The House Budget Committee unveiled its budget Tuesday — and the details are not good news for Indian country.
First: The budget calls for more spending cuts than any previous Republican budget, some $5.5 trillion over the next decade. The pay off would be a balanced budget. But most of those cuts fall into “domestic” spending and that’s the source of most of the federal dollars for Indian country.
Second: The budget repeals the Affordable Care Act or Obamacare. “Obamacare is not working for America’s families, doctors or employers. It is imperative that the President’s health care law be repealed so that we can start over and make targeted, common sense reforms that will improve access to affordable health care choices,” the House Budget committee said.
“This budget repeals Obamacare in its entirety – including all of the tax increases, regulations, subsidies, and mandates” the House Budget committee said. That includes the Indian Health Care Improvement Act.
The proposal would also transform Medicaid into a block grant program, giving the money directly to states. Medicaid now represents some 20 percent of the Indian health system funding.
In a language that’s not English, the report said, “the budget repeals Obamacare’s Medicaid expansion so the program is able to focus on its core mission of serving those in our communities most in need of assistance.” Translation: We’re cutting insurance for those who can least afford insurance. This is nuts. The Medicaid expansion has been the key to making health insurance more available. Since the enactment of the Affordable Care Act there has been a 35 percent decline in the uninsured, according to new data from the Department of Health and Human Services. Nearly 17 million people have insurance coverage under the law. The House budget offers no replacement provisions for those who would lose their health insurance coverage.
This report is full of Orwellian language. Another of my favorites is this line: “We do not invite the across-the-board sequestration cut that would occur if we were to simply budget or appropriate a defense spending level that is above the existing cap mandated under current law.” In other words, the sequester applies to every other part of government, but not Defense. As I mentioned in my last post, this is an attempt to balance the interests of those in Congress who want deep spending cuts with those who want more money for defense.
The budget does not actually appropriate dollars. That is still the job of appropriations committees. But this document would be an overall limit to spending and would force the folks writing budgets to keep their numbers below the caps. This budget is similar to Paul Ryan’s recent approaches to spending and House Democrats said that would mean a cut of at least $375 million to the Bureau of Indian Affairs and a $637 million reduction for the Indian Health Service. But that’s just in direct appropriations. If you reduce Medicaid that could trim as much as a billion dollars from Indian health programs.
The Senate will unveil its budget later this week as well. The goal is to have a budget enacted before April 15. The Senate’s budget will not require a supermajority, by rule it cannot be filibustered. So this budget will reflect the will of the Republican majority in both Houses. The budget still will face a likely veto, especially since it includes a repeal of the Affordable Care Act.
Mark Trahant holds the Atwood Chair at the University of Alaska Anchorage. He is an independent journalist and a member of The Shoshone-Bannock Tribes. For up-to-the-minute posts, download the free Trahant Reports app for your smart phone or tablet.