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Symbolic House Vote Repeals Indian Health Law

WASHINGTON – As expected, the Republican House of Representatives voted Jan. 19 to repeal the national health insurance reform legislation, which was signed into law by President Obama last year. Three Democrats joined all Republicans in the maneuver, which was symbolic, since the Senate is not expected to take similar steps—and Obama has promised to use his veto power even if the Senate were inclined take similar action. The Senate, controlled by Democrats, would need 66 votes to override a veto—a highly unlikely scenario.

The repeal had been closely monitored by Native Americans because the overall health law contains the Indian Health Care Improvement Act, which provides a permanent funding avenue for a variety of Indian health programs and services.

Some major Republicans who voted for the repeal said they supported the IHCIA and would have worked to keep it if they thought there was a chance that the overall bill would succeed in the Senate.

Rep. Don Young, R-Alaska, said there was no chance of the repeal succeeding beyond the House, which is why he supported it, despite also being a strong supporter of the IHCIA. He chairs the new subcommittee on Indian issues in the House.

Young said his vote was difficult, which is why he thought IHCIA should have been separate from the national reform law in the first place. He argued that improving Indian health is a separate issue from health insurance reform for all Americans—one that deserves recognition on its own.

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As promised, the Obama administration took steps to support IHCIA. In a statement, Interior Secretary Ken Salazar noted that the House repeal was harmful to the Indian health law.

“The Affordable Care Act is a vital tool for Native American communities that are working to improve quality of life, overcome health care disparities, and improve wellness and health in Indian country,” Salazar said. “A vote to repeal the Affordable Health Care Act would only turn back the clock on the real progress we are making toward ensuring that Native Americans have access to quality, affordable health care.”

He called the legislation “landmark” and noted that it offers permanent reauthorization to the IHCIA.

The act also provides tax exclusions for individual Native Americans whose tribes have opted to purchase health insurance for their members, and it allows tribes that operate programs under the Indian Self-Determination and Education Assistance Act to purchase federal insurance for employees.

A Department of Interior press release ("Salazar: Repealing the Affordable Care Act Would Set Indian Country Back") noted that American Indians and Alaska Natives are exempt from tax penalties for not enrolling in an exchange plan under the law.