Some blame NCAI for lack of health bill passage


WASHINGTON – There are many people to blame for the lack of passage of the Indian Health Care Improvement Act reauthorization to date, including multiple grandstanding members of Congress. Introspection has also set in, with some Native leaders saying that fault partially lies with the political decision-making of the National Congress of American Indians. NCAI leaders, meanwhile, say not to count out their efforts.

As Indian Country Today previously reported, the reauthorization, which passed the Senate in February, largely failed to make headway in the House of Representatives due to anti-abortion language added to the bill by Sen. David Vitter, R-La. His amendment forbade the use of federal funds to pay for abortions under the reauthorization.

One lobbyist familiar with the situation, said he believes the biggest strategic error on behalf of NCAI and its lobbyists was not realizing that Democratic supporters would not take a stand against pro-lifers to encourage the bill’s passage.

“I was stunned that traditional Democratic allies in the House … believed that it was more important for them to make a point on [abortion] choice than reauthorizing Indian health care,” the lobbyist said. “Tribal leadership really needs to think long and hard about how it wants to move forward [in dealing with House leadership].”

When Vitter posed his amendment early this year, he inserted support letters from the National Right to Life, Family Research Council, and Concerned Women for America organizations into the congressional record. It was a move that some say should have immediately set off alarm bells, especially given the stature of Rep. Nancy Pelosi, D-Calif., as the first female House leader.

Given that backdrop – and the hindsight of the bill’s lack of progress – some tribal advocates are now saying that NCAI officials failed to anticipate the vast problem the Vitter amendment would pose, and should have worked harder with congressional allies to ultimately get that language quashed, so as not to become a sticking point in the House.

“The reality is that from the moment Sen. Vitter tacked on his anti-abortion language to the Indian bill, it was doomed,” said another Washington lobbyist and former House staffer who believes that NCAI and its lobbyists dropped the ball in dealing with the situation.

“The idea that the first-ever woman Speaker of the House would allow a bill that restricts women’s reproductive rights to go through the House on her watch just doesn’t make sense.”

Some have also argued that NCAI should have made more of Vitter’s attempt to narrow the focus of the broad health bill to moral grounds when he himself was embattled throughout 2007 in a highly immoral situation involving his past relations with at least one prostitute while married.

Tex Hall, who presided over NCAI from 2001 – 05, believes that current NCAI leaders should not have feared going to Capitol Hill and telling Democratic and Republican congressional leaders that the Vitter amendment was a “kiss of death.”

“They needed to make the case that this act affects the health and well-being of every American Indian, and that this was not the time or place to put in a morality amendment. You can’t be afraid of playing tough politics, especially in an election year.”

Leaders with the National Indian Health Board had argued the abortion language was inappropriate, and ultimately took the public position that the House failed to take up reauthorization “because Congress could not find funding to pay for the bill.”

On the NCAI side, the reality is that its leaders did come out “strongly opposed” to the Vitter amendment, but only in the final days prior to the Senate vote. Before this, the official NCAI position had been that the amendment was “unnecessary” – much weaker language that some say may have been a strategic blunder in retrospect.

The lack of immediate and strong opposition has been viewed by some observers as allowing tribes to lose critical support from important Democrats, including Senate Majority Leader Harry Reid, D-Nev.

Hall said he does not blame NCAI leaders for their lack of trying, but suggested that every effective leader should always be working to get bipartisan support on Indian issues.

In defense of NCAI, the organization led massive efforts to get tribal leaders and health advocacy organizations to lobby Congress in support of the bill.

Jacqueline Johnson, executive director of the organization, said that given the politics involved in the situation, the only way to get the bill passed through the Senate’s Republican Steering Committee was to codify the abortion amendment – although NCAI, she noted, still opposed the amendment.

She still believes that the bill could move this year, noting that the Senate is scheduled to come back in session in November. She and others have pinned slim hopes on the chance that the House could also meet in a lame duck session, although such a move had not been planned as of press time.

“If there is a vehicle to move it on, we are going to continue to push through the Indian health care bill. We haven’t given up.”

Adding a glimmer of hope to Johnson’s self-admitted optimism, Indian Affairs Chairman Sen. Byron Dorgan, D-N.D., has given signals that he may take action to force the House’s hand via a legislative maneuver.

Meanwhile, NCAI continues to search for a champion to push the bill through in the House this year.

An obvious champion would be Rep. Nick Rahall, D-W.Va., chair of the House Resources Committee, which has long been the principal committee of jurisdiction on Native-specific issues in the House.

But tensions between NCAI and House officials, including some on Rahall’s staff, began before the 110th Congress even started when NCAI leaders called for the removal of Indian affairs from the Resources Committee. Ultimately, that bid failed, and Indian issues continued to be handled by Rahall.

Observers also say that NCAI may have over-relied on its positive relationship with Kimberly Teehee, who assists Rep. Dale Kildee, D-Mich., co-chair of the Native American Caucus.

NCAI has long viewed Teehee as a strong ally, since she was instrumental in helping Kildee form the Native American Caucus in 1997. However, the caucus has no legislative or oversight authority, and it is not recognized under House rules as anything other than a voluntary association.

From 1995-2005, the Native American Caucus played a bigger role in legislative matters than it does now largely because it provided a bipartisan mechanism for Kildee to work with former Rep. J.D. Hayworth, R-Ariz., to back Indian-focused bills.

When the Democrats seized control of the House in 2006, the power roles shifted and the new boss of Indian-focused matters ultimately became Rahall, who had few ties to Teehee.

According to some advocates of the health bill, NCAI’s reliance on Teehee as a top advocate to help get IHCIA through the House was a misstep, given that her base of power basically disappeared when Rahall’s office took over all the substantive work and procedure on most Indian bills.

Contrary to the Teehee argument, Johnson said that NCAI’s outreach to House members on Indian issues is broad and does not rely on any one relationship.

“It really came down to [Pelosi’s] agenda regarding the politics of the issues involved,” Johnson assessed. “This is an election year, and abortion issues are always volatile … which is one of the reasons I still think there will be an opportunity after the election.”