Dorgan: Progress in Congress, but more work needed

This year, Congress had both good news and bad news for Indian country.

The good news was very good. Congress approved and sent to the president the Native American Housing Assistance and Self-Determination Reauthorization Act of 2008.

That’s the law that authorizes basic housing programs in Indian country. It expired in 2007. Getting it back on the books was an urgent priority.

There are very serious housing problems in Indian country. Today, 90,000 American Indian families are homeless or under-housed. Forty percent of on-reservation housing is inadequate. More than one-third of Indian homes are overcrowded.

These are near Third World housing conditions, right here in America. To get to just an “adequate” level of housing in Indian country, we need 230,000 more housing units in Indian country than we have today.

The United States has important trust responsibilities to American Indians, and that includes housing. Sadly, the housing numbers make clear we have a long way to go before we’ve met that responsibility.

Getting the basic Indian housing program reauthorized is a critical first step. Since it began, this program has allowed tribes across the United States to build, acquire and substantially rehabilitate more than 1,600 home rental units and more than 6,000 home ownership units. That’s real progress, but we still have a long way to go.

The legislation also makes some important changes. One of the biggest is new flexibility for tribes to target the housing funds they receive to better meet their local housing needs, through decisions made locally, by tribes themselves, not some federal official in far off Washington, D.C.

I intend to use my chairmanship of the Indian Affairs Committee to keep working to fundamentally reform and improve health care for Native Americans.

Another change allows tribes to use some of the funds to promote economic development in their local area. Good jobs boost wages and incomes and, ultimately, make it possible for better housing in a community. This is an important improvement.

Unfortunately, though, it was not all good news coming from Congress this year on legislation important to Indian country.

A huge disappointment was the failure of Congress to send the president the Indian Health Care Improvement Act Amendments of 2008. We passed it in the Senate, where I chair the Senate Indian Affairs Committee, but it did not clear the House of Representatives.

The need for this legislation was just as urgent as the Indian housing bill. It may surprise many non-Indians – but few Indians – to learn that access to adequate health care for Native Americans is in such crisis that we literally have health care rationing in Indian country. Only 60 percent of American Indian health care needs are met. There’s a saying on many reservations that “if you’re going to get sick, do it before July,” because that’s when the IHS often runs out of contract health money to treat Indian men, women and children.

The consequence is not surprising – widespread and serious health challenges throughout Indian country. Native Americans die at rates six times higher than the general population from tuberculosis, five times higher than the general population rate from alcoholism, five times higher from diabetes, and two times higher from suicide.

This was good legislation. The House should have joined the Senate in passing it. It included important new initiatives that would have dramatically improved Indian health efforts – mental health programs to address unusually high youth suicide rates; long term care programs for those suffering from chronic illnesses; and greater access to Medicare/Medicaid programs for broader health care coverage.

Unfortunately, unnecessary and highly controversial language regarding abortion was added to the Indian health bill and sunk it. Somebody wanted to make a political point rather than focus on increasing health care for Native Americans. As a result, urgently needed improvements for more than 1.9 million people served by the IHS were denied.

We did secure some victories for Indian health in the 110th Congress. In March, at my request, the Senate authorized an additional $1 billion in funds for the IHS. I was also able to secure another $250 million authorization for Indian health care as part of the Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008. We still need to secure appropriations for these authorizations, but they are, even by themselves, important steps in the right direction.

While I am grateful for that progress, I intend to use my chairmanship of the Indian Affairs Committee to keep working to fundamentally reform and improve health care for Native Americans.

The First Americans urgently need and deserve better health care. My pledge to Indian country, as chairman, is to keep working until they get it.

Sen. Byron Dorgan, D-N.D., is the chairman of the U.S. Senate Committee on Indian Affairs.