NURS-6050N22
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Walden University *
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6050A
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Medicine
Date
Nov 24, 2024
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docx
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Uploaded by ologbosele
Reflecting on the first assignment for the course Policy and Advocacy 6050, I must
confess was difficult to choose a presidential level health care topic that isn’t necessarily
a “hot topic” discussed in the everyday news for days, even months on end. Ultimately, I
selected healthcare funding for Native Americans including the various branches of
government the funding may travel through before reaching these frequently overlooked
American citizens. Native Americans are the only population in U.S. that has a
guaranteed right at birth to healthcare services (Warne,2003) These rights were
incorporated into the many treaties signed by U.S. government and tribal nations.
Although these treaties have been broken numerous times, primarily by the U.S.
government, the tribal members of these national are still guaranteed healthcare
services funded by the US government. Congress determines the budget appropriations
for tribal nations throughout the U.S. and has consistently severely underfunded Indian
Health Services (IHS) and tribal health programs so significantly, often tribal members
do not receive basic medical care. The U.S. commission on Civil Rights has identified,
“the funding for healthcare services critical for Native Americans, disproportionately
lower than funding for any other population including Medicare/Medicaid recipients,
veterans and federal prisoners” (US Comm. 2003) More specifically the funding for IHS
services has only increased by approximately 35%, including inflation decreases to less
than 25% per year since 1955 the year IHS was established (US Comm., 2003)
Due to the political uncertainty over the previous 15 years, I have chosen to
explore the impact of Presidents’ Biden, Trump and Obama and their respective
presidential terms related to fiscal and political support of Indian Health Services and
tribal health programs. During the COVID period, when funding appeared somewhat out
of thin air, President Biden appropriated more than $31 billion dollars for tribal
governments from the stimulus relief package signed into law in 2021 (Walker, 2021).
The decision to appropriate funding of this magnitude to a consistently unfunded IHS
had the was a “high profile step toward more equitable treatment after centuries of treaty
violations and failures by the federal government” (Walker, 2021). Senator Nancy Pelosi
stated, “Our promise to them has always been, they (Native Americans) will have a seat
at the table” (Walker, 2021). In 2023, President Biden’s budget demonstrated a
commitment to increased financial support to IHS and tribal health nations by increasing
allocations by 37% over year 2022 percentage. (Center on Budget, 2022) President
Biden allocation “would enable IHS to keep pace with increases in healthcare costs”
(CBPP, 2022).
President Trump campaigned for repeal of Obamacare, the permanent financial
support government support of the Indian Health Care Improvement Act of 1976 (Terry,
2017). President Trump essentially closed long-standing lines of communication, halting
years of social progress with decision to not reconvene the White House Tribal Nations
Summit in 2017(Torres, 2023). Expansion of telehealth programs into tribal lands in
2018 was one of the few highlights in President Trump’s time in the White House (States
News Service, 2018)
During the Obama presidential support for tribal nation was highlighted in 2009
when President Obama signed the Indian Health Care Improvement Reauthorization
and Extension Act, ensuring improved healthcare for tribal nations. U.S. Senator Dorgan
of ND who co-authored the bill stated, “the federal government has trust and treaty
obligations to provide health care American Indians and Alaska Natives, this law is the
first update and modernization of the nation’s basic Indian health care programs in over
a decade” (States News Service,2010)
The extend of uncertainty within the U.S. political environment over the past fifteen
years is evident in reflection of Presidents’ Biden, Trump, and Obama. Political party
affiliations aside, we have an obligation to our First Nations Citizens. The integrity of the
nation relies on our commitment to historical treaties and trust. We can only hope for
continued appropriate financial, governmental, and societal support of our neighbors
and fellow countrymen.
References
Belluck, P. (2009, December 2). New hopes on health care for American Indians.
The
New York Times
,
159
(54877), A1.
CBPP Staff, (2022, April 6).
Analysis of President Biden’s 2023 budget
. Center on
Budget and Policy Priorities. https://www.cbpp.org/research/federal-budget/analysis-of-
president-bidens-2023-budget
President Obama Signs Indian Health Care Improvement Act into Law. (2010, March
23).
States News Service
.
Sarah Terry-Cobo. (n.d.). Affordable Care Act repeal could hurt tribes.
Journal Record,
The (Oklahoma City, OK)
Staff, W. (n.d.).
West River Eagle - West River Eagle
. West River Eagle -.
https://www.westrivereagle.com/
Trump Administration to Help Native Americans Expand Telehealth Resources. (2018,
November 14).
States News Service
.
US Commission of Civil Rights:
A Quiet Crisis: Federal Funding and Unmet Needs in
Indian Country
. (2003).
Walker, M., & Cochrane, E. (2021, March 19). Helping Tribes Fight More Than the
Virus.
The New York Times
, A14.
Warne, D. (2007). Policy challenges in American Indian/Alaska Native health
professions education.
Journal of Interprofessional Care
,
21 Suppl 2
, 11–
19.
https://doi.org/10.1080/13561820701520426
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