A case example of the urban Indian health program
The congressional August recess was over as soon as the Labor Day picnics ended.
Congress returned for five hard weeks of legislating and appropriating before it adjourns for four intensive weeks of campaigning. What laws will emerge is anyone’s guess.
All House members and one-third of the senators are running for their jobs, and voters will decide if they get to keep them on Nov. 7.
Control of the House and Senate is at stake, so it’s not just the candidates who are campaigning in earnest. Everyone is anxious to hit the campaign trail on a full-time basis.
The target adjournment date for both the Senate and House is Oct. 6. With the end of the fiscal year fast approaching on Sept. 30, and not one of the 13 appropriations bills completed, it’s crunch time in Congress.
This is an annual beat-the-clock exercise, with a predictable outcome.
In most years in recent decades, Congress has failed to enact most of the money bills before the fiscal year tolls. Instead, the House and Senate break out the short-term continuing resolution template at the 11th hour and carry over the current fiscal year’s funding levels to the new fiscal year.
Congress almost always returns to Washington in November and December to enact the separate appropriations bills or a further continuing resolution for the ones they can’t agree to pass.
A particularly bruising election – as this one promises to be – usually assures limited agreement on anything, a very small number of finished money bills and very large continuing resolutions.
If the election results in a leadership change from Republican to Democrat in the House or Senate, or both, the outgoing majority will want to conduct as much business as they can, while the incoming majority will want to conclude this 109th Congress as quickly as possible.
Here’s how these dynamics could affect a single program: the urban Indian health program.
When President Bush sent Congress his proposed budget for fiscal year 2007 at the beginning of this calendar year, the urban Indian health program was targeted for elimination. The administration began taking steps to close the 34 health centers all over the country.
In response to a unified Indian lobby effort to save the program, the House restored $32.7 million for the health centers in May. The final vote on the umbrella bill, the Interior Appropriation Act, was 293 to 128.
In case anyone missed the point, the House report which accompanied the bill stated that “the proposal to eliminate this program is rejected.”
The Senate Appropriations Committee concurred in June, adding report language that leaves nothing to the imagination:
“The Committee is dismayed by reports from tribes that the Department of Health and Human Services has instructed the [Indian Health] Service to proceed with plans to close down 34 urban centers, despite the fact that the House Committee on Appropriations is already on record as disagreeing with the proposal for elimination.
“The Committee stresses that no funds were provided in fiscal year 2006 to effect the closure of these facilities and it expects the Department to refrain from any further action until House and Senate Committees on Appropriations have concluded negotiations on the 2007 budget.”
There is enough time this month for the Senate to pass the Interior money bill, for the House and Senate to hold a conference to reconcile differences, for each chamber to pass the agreed upon bill and for the president to sign it into law. Or not.
If there’s a logjam or a veto threat or a game of chicken – or if a senator doesn’t like an opponent’s campaign ad and puts a hold on the bill to stop further action on it – Interior appropriations could stall and be folded into a continuing resolution on Sept. 30.
Where would this leave the urban Indian health program? In limbo. The 2006 fiscal year’s appropriations level would be continued. But Congress didn’t specify a level for 2006.
The administration has the House and Senate bills and reports, and there can be no mistaking what Congress intended to this point. But that intention is not yet law.
Administrators intent on mischief could make some for the program, but few would be so foolish as to poke a stick at appropriators who control their budget.
While waiting for definitive action, the people who staff the urban Indian health centers, as well as the Indian patients who depend on them, would become increasingly apprehensive about the program’s future.
Many a program has faltered in its mission because program managers have been turned into crisis managers in this kind of situation.
If Congress cannot pass the 2007 Interior appropriation, a handful of representatives and senators could reiterate the appropriations report language on the urban Indian health program in connection with passage of the Indian Health Care Improvement Act.
The IHCIA is poised for a Senate floor vote, as well as action in the House committees on Energy and commerce and on Ways and Means.
Restating the intent of the House and Senate on the urban Indian health program for the record of the IHCIA would be a clear and simple way to formally convey the directives.
It also would be an act of kindness for all the people who are totally stressed out about the fate of the urban Indian health centers.
<i>Suzan Shown Harjo, Cheyenne and Hodulgee Muscogee, is president of the Morning Star Institute in Washington, D.C., and a columnist for Indian Country Today.