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Sequestration Will Cost Tribes $130 Million; Plus 800,000 Fewer IHS Outpatient Visits

On Tuesday President Barack Obama will lay out his case that Congress ought to reverse the $1.2 trillion worth budget cuts that are beginning March 1.

Tuesday night President Barack Obama will lay out his case that Congress ought to reverse the $1.2 trillion worth budget cuts that are beginning March 1.

The White House message is that there should be a debate about the long-term deficit, but that Congress should “permanently turn off the sequester.”

That package should have balance and include spending cuts and revenues. As Dan Pfeiffer, a senior advisor to the president, wrote: “And over the long-term, we need to find a solution that does this in a balanced way. The president has already reduced the deficit by over $2.5 trillion, cutting spending by over $1.4 trillion. And he's willing to do more. And we can't just cut our way to prosperity. Even as we look for ways to reduce deficits over the long term, our core mission is to grow the economy in a way that strengthens the middle class and everyone willing to work hard to get into it.”

Mark Trahant

Grow the economy. Those three words should be the heart of the debate because the economic evidence is that the sequester will do just the opposite. (The Congressional Budget Office calls this a “subdued” economy. And, according to The Washington Post, the administration has started preparing to reduce the number of federal employees. “The memo also told agencies to “identify the most appropriate means to reduce civilian workforce costs,” including with hiring freezes, by releasing temporary employees and through early retirement or voluntary separation incentives. In other words: Think hard about how to get rid of people,” The Post said.)

Friday the White House released new details about the stark nature of those cuts, including deep cuts to food safety, mental health, head start, teaching jobs, workplace safety, in other words, across virtually all platforms of the federal government. The total tab: $85 billion, half from defense and half from domestic programs.

“Tribes would lose almost $130 million in funding from the Department of the Interior,” the White House said. Native American program “reductions would be necessary in many areas including human services, law enforcement, schools, economic development and natural resources.”

The White House said, “Indian Health Service and tribal hospitals and clinics would be forced to provide 3,000 fewer inpatient admissions and 804,000 fewer outpatient visits, undermining needed health care in tribal communities.”

That last line means fewer dollars for Contract Health Services, money that’s spent on outside doctors, labs, hospitals, dentists, transportation and other essential health services for American Indian and Alaska Native patients. As a study by the National Congress of American Indians reported, there is already a decrease in real dollars for this Contract Health. “For example, from 2003 to 2008, CHS inpatient admissions declined by 4.0 percent from 14,847 to 14,205. At the same time, billed costs per admission increased 64.0 percent from $16,345 to $26,873. Similarly, from 2003 to 2008, CHS denials increased 88.0 percent from 19,121 to 35,953. During the same period, the cost of unfunded denials increased 296 percent from $43,924,761 to $130,113,907. In 2008 and 2009, only half of Contract Health Emergency Fund cases could be funded, and over 1,000 cases went unfunded each year.” And these numbers are before sequestration.

In addition to the direct hit that Native American programs will take there will also be significant impact to general programs. The White House says 600,000 women will be dropped from the Women, Infants and Children program. “At least 1,600 State and local jobs could be lost as a result,” the White House said. I would add an undetermined number of tribal jobs to that total.

And, at the very moment that Republicans in Congress are saying that the Justice Department, not tribes, should prosecute more domestic violence crimes, the budget for that would be cut dramatically, by some 1,000 fewer criminal cases this year.

Rep. Tom Cole, R-Oklahoma, said on MSNBC’s Morning Joe today that the sequester is a “blunt instrument, but it’s the only one in hand.” Cole and other House Republicans are willing to negotiate where the cuts will occur, but not on the amount of cuts nor on adding any revenue to the mix.

And so the stage is set for Tuesday’s State of the Union.

Mark Trahant is a writer, speaker and Twitter poet. He lives in Fort Hall, Idaho, and is a member of The Shoshone-Bannock Tribes. Join the discussion about austerity. A new Facebook page has been set up at: