Indian Country politics and public policy

Commentary by Mark Trahant

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Joe Pakootas speaks to voters in Walla Walla, Washington. (Photo via Facebook)

Mark Trahant / Trahant Reports

Thirteen days and counting. And the election issue once again is the Affordable Care Act.

A report by the Department of Health and Human Services details the rising costs for individual policies. So after two years of moderate premium increases (2% for 2015 and 7.5% for 2016) premiums are going up sharply in 2017. The is ideal for Republicans because the say this highlights why the law won’t work. So it’s an election issue. Again.

But here’s the thing. Yes, this is a problem. It needs to be fixed. But most people are not impacted, especially in Indian Country. (The problem here is that not enough young people are buying that insurance. There are many solutions to that specific issue.)

Let me explain.

The increase in premiums is only for people who buy their plans through healthcare.gov. Most people who do that get a tax subsidy as part of the deal. And most American Indians and Alaska Natives would be eligible for a subsidy in any case.

Most Americans, and most in Indian Country, do not buy individual plans. Most of us get health insurance through work.

Still other Native Americans benefit from the single greatest success of the Affordable Care Act, the expansion of Medicaid.

If you look at the big picture: More people are covered by health insurance than ever before. Most of the law is working, well, brilliantly.

But Republicans will be campaigning on a repeal and replace pledge. Except there is not now, nor has there ever been, consensus from the Right about what a replacement would look like. There is nothing behind the curtain.

One more thing: Remember that any repeal of the Affordable Care Act is also a repeal of the Indian Health Care Improvement Act.

Fear not. This election should bury the very notion of repeal. Perhaps then Congress will actually tinker with the law (like it does with all legislation) to make it work better. Because if you look at the numbers – all of the numbers – then the Affordable Care Act remains a success story.

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Out on the campaign trail last night, Joe Pakootas had a huge crowd in Walla Walla. He wrote on Facebook: “I am the embodiment of the American dream: a minority that came out of poverty, through foster care, into a minimum wage job, turned CEO and now Congressional Candidate. The incredible support I was shown tonight, whether through each handshake, Pakootas sticker or shirt that was worn, or the uproar of applause when I took my seat, is humbling and encouraging. I never thought I would make it here, but it’s all for the people that I’m fighting. I will stay true to that when I’m in Congress.”

More endorsements.

Chase Iron Eyes was endorsed by the Alliance for Retired Americans, a union-based advocacy group. “Could it be due to the fact that I respect my elders, that I won’t let Washington privatize social security unlike my opponent, or is it that I will lift the tax cap so that those making over $125,000 per year pay the same taxes as those making under that amount already pay,” Iron Eyes wrote on Facebook. “We need you to stand for those who invested their whole working lives laying into social security and are not seeking ‘entitlements’ as politicians say.”

Or not an endorsement. In Fargo, the Forum newspaper endorsed Rep. Kevin Cramer for re-election. The paper says he “has no serious competition. Democrat Chase Iron Eyes is running a shoestring campaign with virtually no help from his party.”

However the Forum makes an eloquent case against Cramer. “If he has a blind spot in this election cycle, it’s his near-worship of presidential candidate Donald Trump. Unlike other prominent state Republicans, who have been muted in their squishy support for Trump, Cramer is positively giddy about the New York billionaire, often acting like a cow-eye high school cheerleader who is smitten by the thuggish captain of the football team. Cramer has been too willing to set aside his oft-stated values of family, faith and decency for a heady ride on the Trump party bus.

In Minnesota, Donna Bergstrom, a Red Lake tribal member, was endorsed by the Duluth News Tribune as a “clear choice.” She is a retired Lt. Col. in the U.S. Marine Corps Reserve. The paper says Bergstrom, a Republican, has “a wealth of research and knowledge, strong positions, even stronger leadership experience, and an impressive resume.”

“I’m not a politician but a common citizen who is concerned over the direction of the state just like you,” she said at the paper’s candidate forum.

And that direction will be settled in 13 days.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com

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