Five ways Indian Country can challenge the policies of the Trump White House

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Official government portrait of President Donald J. Trump even telling us what to think about the president’s success story. Would that be the riches to riches narrative?  (WhiteHouse.gov photo)

 

America First? How about First American First?

Mark Trahant / Trahant Reports

How does Indian Country survive the Donald Trump era?

The new administration is only a few days old and already the chaos of the times have upset business as usual. And possibly the very structure of federal-Indian law.

And it’s not just Washington. The North Dakota Legislature in Bismarck acts as if it has permission to ignore the Constitution and precedent in its relationship with tribes. House Concurrent Resolution 3017 calls on Congress to “modify” the reservation system and put the state in charge.

This resolution will last about fifteen minutes if and when legislators put a pencil to what it would actually cost taxpayers. Right now, for example, the federal government picks up the entire tab for Medicaid for American Indian tribal members. Plus add to that the operation of the Indian Health Service. We’re already talking millions of dollars and that’s only one program, health. What’s really driving this is that North Dakota legislators are angry about Standing Rock and greedy for more oil and gas money from the Mandan Hidatsa Arikara Nation. So North Dakota is ready to assume government expenses for Indian Country across the state? Silly, rabbits.

But Indian Country is now a target and so many Trump supporters are emboldened by an administration that does not know how to say no to those who would trample on constitutional rights. This will be true for many who run federal agencies, state governments, oil, gas, and coal producers, and the Congress. In their mind: Indian Country has had it too good for too long. Imagine that.

So what’s Indian Country’s response to the nonsense? Consider these five ideas.

First. Don’t count out the bureaucracy. I first started covering federal Indian policy during the late 1970s. I was in DC and was interviewing someone about a reform project at the Bureau of Indian Affairs, a plan that I thought made a lot of sense. But my source smiled and responded, “I have seen them come. I have seen them go.” There are many ways to tie up initiatives — even good ones — through the process of government. President Donald J. Trump’s memoranda might fit into this category. Usually an executive order or a memorandum has a legal framework as part of the document, including citing the statutory authority for the presidential action. On Dakota Access and Keystone that reference has been replaced by the logic of “because I said so.” We shall see.

Second. Ronald Reagan famously said government is not the solution, but the problem. This era might flip that idea around because the federal government’s inaction on such issues as global warming will make it less relevant. The rest of the world, even conservative allies of the Trump White House, are moving ahead on climate action. To pretend that oil, gas, and coal are the future is only a fantasy. There may be a temporary uptick in fossil fuels, but that cannot last. This is an opportunity for tribes to look for new allies outside of the federal government, even globally. The America First policy signals uncertainty in global governance so perhaps the counter should be, First Americans First.

Tribes should work closer with cities, states, private companies, and any global government that’s open to help. The federal government is going to be close to useless for the next four years (unless the Trump infrastructure program happens, and includes Indian Country, but there is no evidence of that yet.) The modern city state, think a Seattle, Portland, Minneapolis or a Phoenix, as the real engines of growth in this country. What’s the best way for tribes to become partners?

Third. Young people aren’t playing by the old rules, either. If the president wants change he should look at what young people are already doing — and that direction is very different than his.

Take driving. The data shows that both Millennials and Gen-Xers have less interest in driving (and fossil fuel consumption) than any generation in modern history. A recent report published by Time found a “huge drop of 47 percentage points in 16-year-olds with drivers’ licenses. For people ages 20 to 24, there’s been a 16 percentage point decrease over the same time span. And for those ages 30 to 34, the decrease has been about 10 percentage points.” Young people say they are too busy. Driving is too expensive. And It’s easy to catch a ride.

The Millennials are now the largest generation in America so that disinterest in driving — and fossil fuel consumption — is a powerful trend. Of course this is not always the same in rural areas, including reservations. But it’s key to fossil fuel consumption. Make that less fossil fuel consumption. And a shrinking demand for pipelines.

Indian Country’s greatest advantage right now is young people, more than 40 percent of our total population (compared to about a third for country as a whole.) We have numbers working in our favor and should look for more ways to leverage that.

Fourth. Don’t count out Republican versus Republican. Right now Republicans in Congress are giving President Trump the benefit of the doubt. They are willing to reverse long held positions (such as free trade) because he’s the leader of their party and he claims to lead a movement. But as the decisions get harder, the act of governing gets more complex, this will evaporate.

There is already evidence of this in the debate about repealing the Affordable Care Act. The idea of getting rid of Obamacare was a unifying force. But there is no consensus about what’s next. Republican governors fear that their state budgets will collapse if Medicaid becomes a block grant with less funding. Insurance CEOs fear their future if the mandate to buy insurance goes away while they are still forced to cover pre-existing conditions. And many Republicans in Congress cling to the idea that health care should be left up to families and government should not be involved or fund it. And Republicans who want to win the election know that stripping heath insurance from millions of people is not a winning hand.

Fifth. Document everything and be transparent. The Trump era is already defined by the wacky claim of alternative facts. The antidote is to respond with hard evidence. We know that zealots are eager to reshape the federal government by shrinking it. So let’s document with that really means. What jobs are lost (and how will those be replaced?) I’ve started a spreadsheet and will update it regularly.  This president has promised a new era of jobs. So lost work in Indian Country is not acceptable.

There are many ways for tribes to survive the Trump era. My main point is that we need to think differently. Usually a new presidential term starts with a president trying to bridge gaps and bring the country together. That’s not been the case from President Trump and so we should expect more of the same in the years ahead. It’s more important than ever to have a strategy, a plan for winning. What will it take? Who are potential allies? And what are alternatives that might work?

And, of course, we must start getting ready for the next election.

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

 

Day one: A dramatic restructuring of government, budget cuts ahead

Earthcam image of Women’s March in Washington, DC. Women marched across the globe to send a message to the new president about where the country really stands on issues.

Mark Trahant / Trahant Reports

President Donald J. Trump’s inauguration weekend: Pomp and circumstance. Pettiness and chaos. Huge crowds of supporters. And even larger crowds from the Women’s March in cities and small towns around the world.

If this is day one, remember there are fourteen hundred and fifty-nine to go.

The size of the marches must have been too much for the president’s ego. His press secretary took stage to denounce the media in an angry tirade.

Off-stage the Trump White House was preparing “dramatic budget cuts,” according to The Hill newspaper. The Hill learned of the cuts because senior White House officials have begun telling agency budget officers to prepare for a restructuring of government.

The plan calls for a reduction of $10.5 trillion in spending over the next decade. Except the Trump plan calls for an increase in military spending meaning that domestic programs would have to take even bigger cuts in order to reach the total. One projection: Agency budgets would be cut by at least 10 percent and overall the size of the federal workforce would shrink by 20 percent.

The framework for these spending cuts was developed by the Heritage Foundation and the House Republican Study Committee.

Heritage recommends deep immediate cuts to reach “primary balance” in the budget the first year of the new administration. (Primary balance does not include net interest.)

The Heritage plan calls for elimination of the Violence Against Women Act funding by the Department of Justice, community policing programs, and legal aid. The conservative think-tank says those programs are a “misuse of federal resources and a distraction from concerns that are truly the province of the federal government.”

Tribal governments receive Justice Department grants both in programs directed at tribes and those that are in the broader category of funding for states and tribes.

The Heritage framework proposes a radical restructuring of Indian education programs. It calls for the creation of Education Savings Accounts for students who attend Bureau of Indian Education Schools. That funding would equal 90 percent of the per pupil funding formula. The idea is that students could use this money at any school, including private ones. “Such an option would provide a lifeline to the 48,000 children currently trapped in BIE schools which have been deemed the ‘worst schools in America.'”

The idea stems from a Heritage Issue Brief on Education by Lindsey Burke. The paper says “it’s appropriate for Congress to seriously consider ways to improve the education offered to Native American children living on or near reservations. Instead of continuing to funnel $830 million per year to schools that are failing to adequately serve these children, funds should be made accessible to parents via an education savings account, enabling families to choose options that work for them and that open the doors of educational opportunity.”

The report doesn’t not address what private alternatives, or even what the public school options, are available in remote reservations communities.
Another radical restructuring plan involves Indian housing programs. The Heritage Blueprint calls for a phasing out of subsidized housing programs over the next decade. “States should determine how and to what extent they will replace these subsidized housing programs with alternatives designed and funded by state and local authorities,” Heritage said.

All Indian housing programs, or what’s left of those programs after budget cuts, would be transferred to the Department of the Interior.

The Heritage Blueprint calls for more tribal authority over fracking, limiting the regulatory oversight by the Department of the Interior or other federal agencies.

The Heritage plan would eliminate the Minority Business Development Agency, National Endowment for the Arts, National Endowment for the Humanities, and privatize the Corporation for Public Broadcast. Energy programs that focus on renewable energy and climate change would also be gone.

The Heritage Blueprint does not address appropriations for either the Indian Health Service or the Bureau of Indian Affairs. However The Hill reports one of the architects for the budget is reportedly a former staffer for Sen. Rand Paul, R-Kentucky. Paul proposed a budget in 2012 that would eliminate the Bureau of Indian Affairs and slash the Indian Health Service budget by 20 percent.

The Heritage Blueprint does not address Medicaid spending but House conservatives have routinely called for that program to become a block grant for states.

One difference between the Heritage plan and early reports about the Trump transition team is that entitlement programs would not be subject to budget cuts. Yet all of the plans call for more money for military spending. That puts all the burden on domestic programs, an idea that is unlikely to work.

The official Trump budget proposals are expected within 45 days, according to The Hill. That budget would then go to Congress for debate and approval.

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

Congress votes to repeal Affordable Care Act; kinda, sorta replacement is next

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Mark Trahant / Trahant Reports

Congress has voted to repeal the Affordable Care Act. Kinda, sorta. Because it’s actually way more complicated than a straight repeal of the law.

The House and Senate passed budget resolutions that instruct four committees in Congress to strip funding from the budget. This is important because it means that the actual language of the repeal will only require 50 votes to pass in the Senate (instead of the 60 votes that most bills require). Thus no help is needed from Democrats to make the repeal so.

Yet the  details of that repeal — including what it actually means for the Indian Health Care Improvement Act, a chapter of the law — remain unclear. The language of repeal must focus on budget issues. The final language will be sorted out by the House Energy and Commerce, House Ways and Means, Senate Finance and the Senate Health, Education, Labor and Pensions committees.

And to make matters even more complicated President-elect Donald Trump told The Washington Post Sunday that he wants to replace the Affordable Care Act with insurance for all. What ever that means. Hard to imagine that Republicans in the House will go along. Trump told the Post that Medicaid cuts are not a part of his plan.

So far the actually legislative proposals go the opposite direction and target tens of billions of dollars that states now get for Medicaid expansion. It’s likely that any replacement will be some kind of block grant program that sends a set amount to states instead of funding every eligible person. The Indian health system is budgeted to receive $807,605,000 in fiscal year 2017 from Medicaid (and another 248 million from Medicare). (Previous: The billion dollar dilemma, funding Indian health in the Trump era.)

Under the rules of the Senate the fiscal repeal process is open to amendment. The Senate still must vote on a proposal by New Mexico Democrat Tom Udall to protect Native Americans on Medicaid. “Any reduction in federal payments to the Indian health system would jeopardize the lives and well-being of American Indians and Alaska Natives, as most health care facilities that serve Native Americans are already woefully underfunded,” Sen. Udall said.

The repeal will also likely end federal subsidies for people who buy private insurance on the open market. American Indians and Alaska Natives are eligible for a basic plan at no cost under the current law.

There is a long way to go before the repeal becomes law (and an even longer path ahead for any replacement). More about that later.

But first: There is something Indian Country can do now. There is still time to sign up for Medicaid, Medicaid expansion, the Children’s Health Insurance Program, and insurance found on the exchanges. This is money that will benefit the Indian health system for at least a year and as long as four years. This act of defiance will not only bring money to a local clinic or hospital, but it will pressure state lawmakers to find a solution for the people who already have Medicaid.

The Affordable Care Act in Indian Country has been a steady success. The law did not result in immediate full funding for Indian health. (In fact: I think the Indian Health Service could have done a lot more to sell the insurance programs to individuals.) Nonetheless Medicaid collections in the Indian Health Service budget have increased by more than 50 percent since the law was enacted. There are still far too many patients in the Indian health system who are uninsured. (Yes, I know, a treaty right, but one that’s not fully-funded.) The fact is patients who carry health insurance, including Medicaid, have more options in terms of care, especially when patients need treatment or specialists outside of the Indian health system. Unlike Medicaid, the Indian Health System is funded by appropriations. Healthcare services are limited by that funding.

American Indians and Alaska Natives still are uninsured at higher rates than the rest of the country. A report by Kaiser Family Foundation said too many Native Americans “have limited access to employer-sponsored coverage because they have a lower employment rate and those working tend to be employed in low-wage jobs and industries that typically do not offer health coverage.” Kaiser said Medicaid and other public coverage “help fill this gap, covering one in three nonelderly American Indians and Alaska Natives. However, even with this coverage, nonelderly American Indians and Alaska Natives are significantly more likely to be uninsured than the national average (21 percent vs. 13 percent).”  And when it comes to children, “Medicaid plays a more expansive role … covering more than half of American Indian and Alaska Native children.” Yet the uninsured rate remains nearly twice as high as the national rate for children at 11 percent.

This Sunday was another deadline for people to sign up for insurance through the exchanges. But American Indians and Alaska Natives are exempt from that deadline. As healthcare.gov puts it: “Members of federally recognized tribes and ANCSA shareholders can enroll in Marketplace coverage any time of year. There’s no limited enrollment period for these individuals, and they can change plans up to once a month.” This is a zero cost plan. And signing up now is an act of defiance.

Remember there will be a transition once Congress comes up with a replacement plan. Adding more people to the rolls of Medicaid, Medicare, Children’s Health Insurance, and market exchanges is one way to demand that Congress come up with an alternative and not just destroy what’s in place.

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Link: Interactive version of graphic.

So what will a replacement bill look like? That is impossible to know. There are at least four Republican alternatives that are little more than concept papers at this point.

On Sunday, Sen. Rand Paul, an ophthalmologist, R-Kentucky, who voted against repeal (because there was no replacement plan) said he would offer his own. A previous plan by Paul would have cut the Indian Health Service budget by more than 20 percent. He told radio host Laura Ingraham that Native Americans “don’t do very well because of their lack of assimilation.”

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Tom Price is the nominee to head the Department of Health and Human Services and a critic of the Affordable Care Act. He has proposed his own plan to replace the law that relies on tax credits and other “market-based” solutions. (GreatAgain.Gov photo)

Tom Price is a surgeon, a member of Congress, and President-elect Donald Trump’s pick to run the Department of Health and Human Services. He has proposed his own replacement for the Affordable Care Act, the Empowering Patients First Act. His basic premise is to lure people away from insurance subsidies by offering tax credits, health savings accounts, and market-based incentives. But his plan was dismissed by a lot of Republicans because the tradeoff of a market-based health care system is that millions of working Americans will lose access to any insurance. The Fiscal Times says Price’s plan “Price would foster an insurance market very welcoming to young, healthy and financially self-sufficient people but hostile to sicker and older people.” Price’s plan (like Ryan’s A Better way) allows individual Native Americans to contribute to a Health Savings Account “regardless of utilization of IHS or tribal medical services.”

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House Speaker Paul Ryan starts his reform proposal with “A better way.” The main idea is that insurance should be more competitive, creating more options for consumers.  “Patients with pre-existing conditions, loved ones struggling with complex medical needs, and other vulnerable Americans should have access to high-quality and affordable coverage options. Obamacare’s solution was to force millions of people onto Medicaid, a broken insurance program that has historically failed lower-income families,” according to the policy paper. The plan says that American Indians and Alaska Native should be able to purchase care outside of the Indian health system with health savings accounts. “This gives American Indians more choice in where they receive care.”

Rep. Tom Cole, R-Oklahoma, and a member of the Chickasaw Tribe, has said that a replacement bill must include provisions for the Indian health system. He has not advocated for a particular plan but wrote in a column last week that “opponents of Obamacare have yet to settle on one specific replacement alternative, but there is a broad consensus about the core foundation upon which a replacement plan will be developed. Simply put, Americans should have access to more choices in health care plans, have a range of prices that make health care affordable to everyone, and a revised set of current rules and regulations to give Americans greater flexibility in purchasing and keeping their plans that aren’t dependent on where you live, who you work for, or what pre-existing condition they may have.”

Sen. Lamar Alexander is chairman of the Senate Health, Education, Labor and Pensions Committee. The Tennessee Republican has said he only wants to see the Affordable Care Act repealed once there are concrete, practicable reforms in place. He said his first focus will be on making sure that the insurance system is stable and fixing the exchanges where 11 million people have signed up for policies.

Alexander also wants states to have more flexibility with Medicaid, determine the rules about how that money could be spent.

One way that could occur is to cap the spending that each state gets for Medicaid, shifting to a set amount per person. According to the Kaiser Family Foundation: “Proponents of per capita cap proposals argue that this structure could reduce federal spending and promote flexibility for states.  However, such policies may be difficult to implement and may result in cost shifts to states if pre-determined growth rates are lower than expected program spending.”

It’s unclear how the federal match for American Indians and Alaska Natives would work under this scenario. Nor is there a guarantee that Native American recipients of Medicaid (or whatever plan follows) would not be required to come up with a co-pay for medical care. That idea would crush the notion that Indian health care is a pre-paid federal obligation.

I would not bank on any of these plans becoming law. There is no easy or fast way to enact a new health care law. As Ezra Klein wrote in Vox: “Donald Trump likes to say he’s going to repeal Obamacare and replace it with ‘something terrific.’ Sadly for everyone, that’s probably not possible. What is possible is repealing Obamacare and replacing it with something that makes a different set of equally painful trade-offs.” The replacement of the Affordable Care Act will need 218 votes in the House and 60 votes in the Senate. The problem is that the very ideas that will improve prospects in the Senate, will likely weaken the case in the House.

So here are the three most important things to remember. First: Repeal can happen quickly. Second: Signing up for an insurance program now is an act of defiance. And, third, Congress is going to have a hell of a time agreeing on a replacement. It’s more likely that we will see chaos before we see consensus about the “what’s next?”

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

History to be made as Native legislators take on leadership roles across country

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Speaker Bryce Edgmon is the first Alaska Native in that post. (360North.Org photo)

Mark Trahant / Trahant Reports

Last year I expected a record number of Native Americans to get elected to offices across the country. There were just so many really superb candidates running for Congress, state legislatures, and statewide offices. At one point my list topped a hundred candidates. Of course it didn’t turn out that way. Too many of those exceptional #NativeVote16 candidates lost. But my tally to date: Sixty-six elected representatives and senators.  So the 2016 election cycle turned out to be more of a rebuilding year instead of one that broke records.

Yet it turns out there is still history to be made.

State legislatures are convening around the country this month and there is an interesting twist: Native Americans are in key leadership positions in at least seven states. That’s impressive — and critical right now because of the types of conversations that will be going back and forth between Washington, D.C., and state capitals about Medicaid, health care and energy policy.

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Interactive version of this graphic here.

Alaska is a great bipartisan example.

Two years ago former Sealaska chairman Byron Mallott, Tlingit, was elected the state’s Lt. Gov. (He was the Democratic Party’s nominee for governor, but joined an independent fusion ticket along with Gov. Bill Walker.) The Walker-Mallott administration elevated Native issues to an unprecedented level of influence. One of the governor’s first appointments was Valerie Nurr’araaluk Davidson, an Orutsararmiut Native Council tribal member, and a long time health advocate, as the state’s commissioner for the the state’s Department of Health and Social Services. She will be the one negotiating with the Trump administration about what Medicaid will look like if Congress acts to repeal the Affordable Care Act.

Then the state legislature and the Walker-Mallott administration have been at odds over state spending and resources. Alaska has a multibillion dollar budget deficit largely because of the state’s reliance on taxes from oil and gas. As The Fairbanks Daily Miner put it: “Fortunately for the state, previous years when oil revenues were high allowed legislators to sock away billions of dollars in savings accounts. Unfortunately for the state, it was easier for legislators to spend from these savings accounts than make the hard decisions that would put Alaska on a path to a balanced budget.” Further complicating that budget challenge, Alaska citizens are paid a per capita distribution instead of paying income or other general taxes.

So after this election a new alliance was formed in the legislature to try and come up solutions, three Republicans and two independents joined the Democrats to form a majority caucus. The Speaker of the House in this coalition is Bryce Edgmon, Yup’ik. He said his native background is how he views the world. He told the Bristol Bay Times: “I know it’s not only my children and maybe their children’s future, but it’s also the future of our way of life out here in rural Alaska and a lot of our Native villages.”

There are now eight Alaska Natives in the legislature representing both parties. Rep. Sam Kito III, Tlingit, is chair of the Labor & Commerce Committee as well as the Legislative Council (a joint committee with the Senate). Neal Foster is co-chair of the Finance Committee.  And Dean Westlake, Inupiaq, is chair of the Economic Development Committee and Arctic Policy. In the Senate, Lyman Hoffman, a Democrat who caucuses with Republicans, is co-chair of the Senate Finance Committee. The House Minority Leader is Charisse Millett, Inupiaq. In a previous legislature, Millett was instrumental in legislating Alaska Native languages as official state languages.

Actually I wrote “bipartisan.” That’s probably the wrong word for what’s occurring in Alaska because a few elected representatives run for election identifying with one party, only to caucus with the other after the election. (Perhaps a model for Congress?)

Oklahoma and Montana are the two states with the most Native legislators, nine. A larger group of Native legislators makes it easier to form a caucus so members can work together on issues important in Native communities. And both states have an active Native caucus.

Oklahoma legislators are leaders in both parties. In the House, Rep. Mark McBride, Potawatomi, is the Assistant Majority Floor Leader. Rep. Chuck Hoskin, Cherokee, is the Minority Whip. And in the Senate, Anastasia Pittman, Seminole, is the Assistant Democratic Leader.

Montana’s newly elected Rep. Shane Morigeau, Confederated Salish and Kootenai Tribes, will serve in leadership this session as Minority Whip. It’s a rare honor for a freshman.

Montana’s American Indian caucus was an important voice in the last legislature on issues ranging from tribal college funding to water compacts. “We’ve been literally and figuratively the minority’s minority,” Rep. Susan Webber, Blackfeet, told the Billings Gazette. “I know it looks like we have a lot of people in the Indian caucus, a lot of people were elected, but in reality it should be more. But just us getting in there, from my perspective, is a real positive.”

A critical challenge for the American Indian Caucus this session will be Medicaid. Montana came late to Medicaid expansion under the Affordable Care Act but its impact has been swift. The state’s uninsured rate dropped from 20 percent in 2012 to 7.4 percent last year. A report by The Montana Budget and Policy Center says a repeal of the Affordable Care Act “could have disastrous impacts on Montana, putting at risk the health care coverage of over 142,000 Montanans who have benefited from ACA measures. At the greatest risk are the over 61,000 Montanans who gained access to affordable health care coverage through Montana’s Medicaid expansion plan.” Worse: the report found that “repeal could cause a greater number of uninsured Montanans than before the ACA was enacted.”

Montana Budget and Policy says 8,000 American Indians are enrolled in insurance through the Medicaid expansion program. Third-party insurance, such as Medicaid, has added nearly a billion dollars to the Indian Health Service budget. “Nationwide, reimbursements at IHS facilities, tribal operated facilities, and urban Indian clinics have increased 21% since the expansion of Medicaid,” the report said. “In 2014, nearly 40% of American Indians did not have health insurance, but Medicaid expansion represented one of the most significant opportunities to expand coverage for American Indians.”

This is important because if Congress repeals the Affordable Care Act, it will be up to state governments to pick up the pieces (as well as the cost) or strip millions of Americans from health insurance coverage. Repeal without new resources could devastate the Indian health system.

Other states where Native American legislators are included in the leadership structure: Hawaii, where Andria Tupola is Minority Floor Leader; and in Colorado, Rep. Joseph Salazar is a committee vice chair.

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Sen. John McCoy is the chair of the Washington Senate Democratic Caucus and will help foster the party’s vision and values during the session. (Legislature photo)

In Washington Sen. John McCoy, Tulalip, has been a long-time champion of issues that are important in Native communities.

McCoy sponsored legislation to close coal burning power plants and “dramatically reduce the amount of coal burned to generate energy for Washington residents, reducing greenhouse gas emissions in Colstrip by 5 million tons — the equivalent of a million cars — a year.”

The senator says Washington Republicans and dental lobbyists are blocking the creation of a mid-level dental practice along the lines of what’s been done in several states. “Indian country may not have the loudest voice in Olympia, but it still has basic needs,” McCoy wrote in The Seattle Times.

“The idea is pretty simple — allow native communities to train and recruit dental therapists to help clear the backlog of an ongoing oral-health crisis. The research is alarming — one-quarter of Native Americans aged 35 to 44 years have fewer than 20 of their natural teeth,” he wrote. “The dentists also ignore the groundbreaking success of similar programs in other states. It’s been working for 11 years for indigenous communities in Alaska, where 45,000 people are seeing reliable providers for the first time in their lives.”

This issue is not going to go away. A new national survey reports that 45 percent of U.S. voters say they go without dental care because of cost or lack of insurance. But 8 of 10 favor adding midlevel providers as a solution. “Good oral health is critical to overall health, yet policies to expand access to dental care do not reflect this,” said Tera Bianchi, project director of the Dental Access Project at Community Catalyst. “Dental therapists offer better access to care for the most underserved populations in a cost-effective way to the system. They are a smart, effective bipartisan way to improve access to care.”

And this session McCoy will be the he face of the Democratic Party, chairing the caucus where he says he will help “foster the vision and values of Senate Democrats as they navigate the 2017 session.”

In other words: Sen. McCoy has a seat at the head of the table.

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

Draft. Native Legislators spread sheet

Good morning. Writing. So I started last year thinking that 2016 would be a record year in terms of Native Americans winning office at state and congressional level. Did not happen. But here is a twist: Seven states now have Native American legislators in their leadership.

Spreadsheet of elected Native leaders shows 57 elected in 15 states.

Who am I missing?

https://docs.google.com/spreadsheets/d/1f6__GVaWJjpKSTFvCBZDef5vL5gIzdAsn15UyXTB1M8/edit?usp=sharing

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Reflecting on the dangers and promises of the Trump era #NativePolicyDebate

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A president unlike any since, well, Andrew Jackson

Mark Trahant / Trahant Reports

A terrible year? Elias Boudinot considered 1832 as such.

The year started with the Cherokee Nation winning its case in the U.S. Supreme Court, only to be followed by a message of “so what?” from President Andrew Jackson. Boudinot’s home was slated for auction by the state of Georgia; the idea being that settlers would then force Cherokees to flee their own homes. And, Boudinot resigned his job as editor of The Cherokee Phoenix because he believed the Chief John Ross was dictating the newspaper’s positions. He wrote: “I do conscientiously believe it to be the duty of every citizen to reflect upon the dangers with which we are surrounded; to view the darkness which seems to lie before our people, our prospects, and the evils with which we are threatened; to talk over all these matters, and, if possible, come to some definite and satisfactory conclusion.”

Boudinot had three goals for The Cherokee Phoenix. To inform tribal citizens as “a free paper,” one that would “always be open to free and temperate discussions on matters of politics, religion, &c.” Second, to publish a defense of “our rights.” And, third, the “representation of our grievances to the people of the United States.” He was particularly troubled by the last idea, reaching out to Americans. “We can say nothing which will have more effect upon the community, than we have already said,” Boudinot wrote. “The public is as fully apprised as we can ever expect it to be, of our grievances. It knows our troubles, and yet never was it more silent than at present. It is engrossed in other local and sectional interests.”

And so we shift to 2017. Our challenges, of course, are different. But the idea of a serious reflection, a public discourse, about the policy choices ahead are as important now as it was then. I have been thinking about 1832 for two other reasons: First, Donald Trump will be a president unlike any we’ve seen since, well, Andrew Jackson. And, that era, like this is one is where reason and facts are discounted. There is a meanness in our public square. On top of that, our next president makes things up and yet some still people believe him. So, I guess, the public is once again as fully apprised as we can ever expect it to be.

Of course Trump supporters from Indian Country tell a different story.

They see him as a new champion of tribal sovereignty, especially when the focus is on energy development. (Previous: The deep divide on energy and climate issues.) The problem with this is that folks who think fossil fuels are our future are on the wrong side of history. In order to buy the logic of more oil, gas, and coal, you have to pretend that climate change is neither real nor human caused. The trade off requires believing that profits and perhaps a few jobs are better measures than science. And, to do this at a time when the rest of the planet is moving on. Linking Indian Country’s future to fossil fuels locks us into declining technology and shrinking markets.

One way a Trump administration could really help Indian Country is infrastructure. But we know so little about the president-elect’s plan and how that could impact American Indian and Alaska Native communities. (Other than pipelines, that is.) The president-elect has called building roads, water systems, electricity grids, and telecommunications as “a golden opportunity for accelerated economic growth.” But that plan has two serious obstacles for tribal nations. Trump promises to use private partnerships to pay for these projects. And, he wants the initiative to give “maximum flexibility to the states.”

Watch for this phrase in the coming weeks … “and tribes.” The Congress and the Obama administration often inserted that language into law and public policy to open options for tribes that were similar in scope to state governments. Will that continue? Or is giving states “maximum flexibility” a single paradigm?

That brings me to the two greatest challenges ahead in a Trump administration, the repeal of the Affordable Care Act and the severe budgets that are ahead.

Repealing the Affordable Care Act, or Obamacare, will likely be the first vote in Congress. But repeal is the easy part. “Then what?” is a much more difficult question. House Speaker Paul Ryan, R-Wisconsin, recently told the Journal-Sentinel that a replacement bill will “take time.” He said“clearly there will be a transition and a bridge so that no one is left out in the cold, so that no one is worse off. The purpose here is to bring relief to people who are suffering from Obamacare so that they can get something better.”

Rep. Tom Cole, R-Oklahoma, has said any replacement of the Obamacare should include a new version of Indian Health Care Improvement Act. That’s the ideal. But what about funding? The Indian Health Service has been historically underfunded. And the Affordable Care Act has added money, especially through Medicaid expansion. That may be the most successful element of the law and it nets the Indian Health System substantial resources, money that is supposed to remain at local clinics and hospitals.

It’s important to remember that the Affordable Care Act has substantially reduced the number of uninsured Americans, including American Indians and Alaska Natives (from 16 percent in 2013 to a historic low of 10 percent in 2015). This is the number to think about: More than half (51 percent) of Native children are insured via Medicaid and the Children’s Health Insurance Program. This is important because those who have insurance are more likely to get a broader range of health care services than those who only rely on IHS for care.

So depending on how the repeal and replace legislation unfolds between 11 million and 60 million people could lose health insurance coverage. And the Indian Health system could lose hundreds of thousands of dollars in funding streams.

Then the issue of money for American Indian and Alaska Native programs might be the toughest one of all. I have been writing for years about austerity as a trend. We have been lucky during the Obama years because Indian Country was mostly held harmless (especially in the health arena).

But President-elect Trump’s choice for the Office of Management and Budget is Rep. Mick Mulvaney, R-South Carolina. He’s one of the most strident voices in Congress against federal spending (even voting against his own party when budgets were not harsh enough).

While in Congress Mulvaney championed reducing the size of the federal workforce by at least ten percent. One of his proposals would have limited agencies to one hire for every three departures. He advocates increased work by contractors while reducing total costs.

Mulvaney defended the 2013 sequester — a disaster in Indian Country — as something that “bodes well for the future.”

“We are, all of us, Democrats, Republicans and independents alike, having a national dialogue about what is really important for our government, and what our government could do without,” Mulvaney wrote. “And it has been much too long since we have done that.”

That conversation will define 2017.

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