It’s such a simple thing: Every citizen should have a voice at the table when decisions are made. It’s a powerful notion because no democracy can sustain itself unless all of its people, all of those who have a stake in the outcome, are included.
But that idea remains illusive. And never more important.
What does a seat at the table look like? It means more Native Americans win election to office as governors, members of Congress, U.S. Senators, mayors, county commissions, judges, members of state legislatures, and, yes, why not, even the White House. Indian Country deserves more of a voice, both in terms of fairness and as elected representation that’s based on our share of the population. Wait. That’s fairness, too. (Previous: Indian Country wins with more representation in the states.)
Then there are elected offices that we don’t think about, yet are important, and by definition, are that seat at the table. Claudia Kauffman is running for such a job, Commissioner for the Port of Seattle. This is a $650 million a year public business that manages Seattle’s seaport, airport, and a portfolio of real estate. It has its own police and fire departments. Tribes and native people are impacted by port decisions ranging from cleaning up rivers and salmon habitat to regulating oil drilling rigs that berth in Seattle on their way to Arctic waters.
Kauffman grew up in Seattle’s Beacon Hill as the youngest of seven children. “I come from a family with a long history of giving back to the community,” Kauffman says on her web site. “A family with strong and well grounded values and connection to our community, our environment, and our future. I will work to bring trust back into government, to provide leadership in the direction of the Port of Seattle, and bring family wage jobs.”
A couple of years ago Kauffman told the port commission that it could use her perspective as a working mother, a small business owner, and a community leader. “My record of public service includes working closely with state, federal and tribal governments, which I believe, makes my experience unique and beneficial to the Port of Seattle Commission,” she wrote. In the state Senate Kauffman said she worked on transportation, international trade and economic development. “I led the Senate in the successful passage of the MicroEnterprise Development in which we funded training for small business owners … my work with the Muckleshoot Indian Tribe provides critical connections, understanding and perspective.”
In her campaign brochure, Kauffman said she will build on her tribal contacts and strengthen ties with the 29 tribes in the state. Tribes “are large employers,” Kauffman said. “In 2010, they paid $1.3 billion in wages and purchased $2.4 billion in goods and services.”
This will be a challenging race. She’s running for Commissioner Position One, against a well-funded incumbent, John W. Creighton III. Also on the August primary ballot will be Ryan Calkins and Bea Querido-Rico. (This is a non partisan election for voters of King County, Washington.)
Creighton is the longest serving port commissioner and one of the commission’s best fundraisers.
But Kauffman is no stranger to that world. She raised nearly $300,000 in her bid for the Senate and she was one of those candidates who worked incredibly hard knocking on every door at every opportunity. She also has a political organization — a network of people who are willing to work extraordinarily hard to win an election.
One election will not erase what is Donald J. Trump. Most of his voters see him as the antidote to business as usual. He’s shaking thing up (even if there is disagreement on specific issues). Destroying health care? Yes. So what. At least something new will surface.
Montana voters, it would seem, have a lot more at stake than most. This is a state where Medicaid expansion is working well. That very idea will be repealed in the Republican plan. So this election is a big deal.
Except voting is soooo hard. Especially when it’s a special election and no one is running for president.
Some numbers: Denise Juneau lost that same congressional district in November earning 201,758 votes to Ryan Zinke’s 280,472.
On Thursday Greg Gianforte won with 50.2 percent of the vote and only 189,240. In November 74.44 percent of the electorate showed up. Thursday night it was 54.4 percent.
Glacier County is a case in point. This is where the Blackfeet Nation votes. Juneau won the county by more than two-to-one over Zinke. In November more than 5,000 people voted. Last night: About 2,400.
So Democrats may be soothed by the fact that Gianforte lost nearly 7 points from Zinke’s win in November. The idea being that Democrats are picking up strength in a pro-Trump state. Matthew Yglesias wrote as much for Vox. That geography determines so much of the Congress and that turns into a Republican advantage. But, “for prognostication purposes you don’t just want to know who wins or loses a special election — you want to know the margin,” he writes. “To win by only seven in Montana, a state that Trump won by 20 points, is a clear sign that seats Trump won by four or five points or more aren’t truly safe.”
True enough. But it really will depend on who shows up at the polls in 2018.
Yes this was a special election. Yes the rules were confusing (changed along the way) about where to vote and how.
But all of that is just is a call to do better. We need to figure out how to get more people engaged. (Again.)
To me the real loss in Montana is that in an era when so much is at stake, 321,000 voters passed. They voted that voting is not all that important. — Mark Trahant
Reality TV works for one simple reason: The antics of the characters are beyond what’s believable in fiction. It’s compelling drama because normal people do not do such things. So part of watching is to find out when the story arc ends, to discover when the situation becomes “normal” again. (Even though the story does go on and on and on.)
That’s why the presidency of Donald J. Trump would make a terrible novel or screenplay: There’s no mechanism to suspend disbelief. Tell the story about a four-month term in the White House, a time marked by so much chaos, unprofessionalism, and distraction, and a reader (and especially an editor or producer) would shake their head and say, “Try again. This story is not believable.”
That’s why only the metaphor of reality TV works. America the unbelievable.
Last week the best moment of the new Trump Administration was the one where the president smiled in Saudi Arabia and said only 26 words. This was terrible reality TV but we all watched knowing that it was likely just a pause. Something outrageous must be coming up next.
The White House Reality Show is entertaining.
Meanwhile more important stories are still being written and played off-screen. That’s why our focus must return to the policy fights ahead: How this country (and our planet) deal with climate change, how we stop the rigging of elections, and, how we make certain the court system is fair. Next week the White House will formally send Congress its budget plan for the next year. We already know this plan will be nonsense. Another distraction. The real work of budgeting will occur in Congress and it will require votes from both Democrats and Republicans to make it so.
At a House hearing last week, for example, Rep. Tom Cole (R-Oklahoma) said he was disappointed in a White House recommendation to cut $5.8 billion from next year’s funding for the National Institutes of Health. He such a draconian cut would stall so much progress from recent investments.
In other words: No sale. Across the Congress, across the government, this same notion is being repeated. Eliminate the Corporation for Public Broadcast? No sale. Down the list the message is much the same, eliminate the Denali Commission? No sale. Etcetera, etcetera, etcetera.
Paying for health care
But while Congress might rewrite the budget in some areas, there are real dangers ahead. I’m obsessed with what this bunch is doing to the funding streams for health care, especially Medicaid.
This is what the Trump Show hides: The House’s American Health Care Act does much more than roll back the Affordable Care Act (or Obamacare as they like to say.) It ends a Medicaid program that works. It’s the single most effective form of “government” insurance that secures health care options for 62.3 million Americans. To add a little perspective here: Medicare — supposedly untouchable in politics — insures 43.3 million seniors.
These are huge numbers. Medicaid is expensive. And we all pay for this plan. As we should. It’s one of the best things this country does.
So it’s no wonder that Speaker Paul Ryan and Republicans are eager to make this go away (both because it costs so much and because it requires a lot of taxes to pay for this enterprise).
This is an issue where the philosophical divisions run deep. Every Republican wants to spend less federal money on this program. Significantly less. Once you do that, there will be fewer people who participate in this public insurance program. That’s math, not politics. The House plan (according to the Congressional Budget Office) strips $880 billion from Medicaid funding in order to reduce health care taxes on wealthy people by $883 billion. Tit for tat.
Watch this debate closely. Parse every word. The Republicans in the Senate who say they champion Medicaid often only talk about Medicaid expansion. And that’s followed by, there should be a transition to something else (namely, block grants that states cannot afford). What else? How does that work? And who pays?
At a town hall in Anchorage last week, Alaska Sen. Dan Sullivan followed this script to the letter. According to The Alaska Dispatch News the Republican senator told a contentious town hall, that he wanted to make sure the people who received health care coverage under Medicaid expansion “do not have the rug pulled out from under them.” Medicaid for now. Then something else. What else? How does that work? And who pays?
The answer is to protect the framework of Medicaid (and if we were smart, enhance and expand it). It’s the one part of Indian health funding that’s growing and already accounts for the insurance of record for more than half of all our children. (And, this is really important, third-party insurance billing, which includes Medicaid, is money that stays at a local IHS clinic or hospital. It does not go into the general budget.)
Medicaid is a partnership between the federal government and the states. So states set many of the rules, federal government then agrees or not, and pays only a portion of the bill. But patients within the Indian Health system are usually eligible for a 100 percent reimbursement.
So states set the rules for Indian Country — including limitations — yet don’t pay the cost. Already six states are already looking to tighten Medicaid rules. Arizona is keen on adding work requirements. Wisconsin wants drug testing (imagine the trap that sets for patients in opioid treatment programs). Maine wants to test assets beyond income. The goal of each new regulation is to shrink the number of people insured by Medicaid.
Medicaid works, especially in Indian Country
I’ve heard Republicans say they like the results of Medicaid but that we as a country cannot afford it. That’s particularly troubling because Medicaid is more efficient that private insurance. (Even with its convoluted payments from the federal government to states and Indian health programs). How can that be? Julia Paradise, associate director of the Program on Medicaid and the Uninsured for the Kaiser Family Foundation, says Medicaid acts as a “high risk pool.” Because so many people are excluded (or out-priced) from private insurance Medicaid is the only option. “Among adult Medicaid enrollees who are not working, illness or disability is the main reason. By covering many of the poorest and sickest Americans, Medicaid effectively serves as a high-risk pool for the private health insurance market, taking out the highest-cost people, thereby helping to keep private insurance premiums more affordable.”
The Senate is now busy rewriting the House’s awful health bill. It will be a different entity, that’s for sure. But will the Senate protect (and if they are smart, enhance and expand) the best basic public health insurance program that we have now? There is no evidence to suggest that. And too many people are watching reality TV to even notice.
The flurry that is the Trump Administration continues to impact Indian Country in ways that are expected — as well as those that surprise. A nasty surprise at that.
The latest offering is a presidential signing statement that targets federal programs that serve American Indians, Alaska Natives, as well as those that fund historically black colleges. Because this statement is attached to the spending bill that just passed Congress, H.R. 244, it gives the Trump Administration legal cover to cancel grants and funding streams already in motion.
My Administration shall treat provisions that allocate benefits on the basis of race, ethnicity, and gender (e.g., Division B, under the heading “Minority Business Development”; Division C, sections 8016, 8021, 8038, and 8042; Division H, under the headings “Departmental Management Salaries and Expenses,” “School Improvement Programs,” and “Historically Black College and University Capital Financing Program Account”; Division K, under the heading “Native American Housing Block Grants”; and Division K, section 213) in a manner consistent with the requirement to afford equal protection of the laws under the Due Process Clause of the Constitution’s Fifth Amendment.
In other words the Trump Administration doesn’t want to spend money on Native American housing block grants or on HBCUs. (And that makes me wonder, are tribal colleges next?) The spending bill included some $654 million for tribal housing programs.
Will the Trump Administration spend the money that’s appropriated? That’s now a real question. The signing statement is a serious threat to appropriations for this year.
Presidential signing statements are extra-legal authority. No. That’s not right either. The American Bar Association said in 2006 that this process undermines the law. It’s an invention says a president knows more than Congress. Signing statements have been around since James Monroe. But, according to the American Presidency Project, Andrew Jackson was a fan. “In May 1830, Andrew Jackson wrote an message to the House stating his understanding of the limits of an appropriation: “the phraseology of the section which appropriates the sum of $8,000 for the road from Detroit to Chicago may be construed to authorize the application of the appropriation for the continuance of the road beyond the limits of the Territory of Michigan, I desire to be understood as having approved this bill with the understanding that the road authorized by this section is not to be extended beyond the limits of the said Territory.”
The Trump White House is eager to destroy the federal government as it exists now. And this signing statement is a sneak attack. — Mark Trahant
The House of Representatives passed the American Health Care Act by four votes, 217 to 213. The legislation now moves to the U.S. Senate. If this bill becomes law it will do five things: Cut taxes for people who make a lot of money, end health insurance subsidies and much of the coverage from Medicaid, cause more people to go uninsured and eventually bankrupt, and frame the most important political debate in a long time.
Every Republican who voted for this mean-spirited bill must now defend against every American who has any problem with insurance or health care. (I know that’s not fair. But it’s essentially what happened to the Democrats.) You get a doctor’s bill you don’t like: Blame Trump and Ryan. Lose insurance coverage at work: Ditto. This is why the optics are so lousy for Republicans, the health care system is now their mess.
Oh. I know. This bill is not law yet. And it’s not likely to be. But it doesn’t matter. Months after the House voted its first repeal of the Affordable Care Act people reported that they thought the law was gone. It was not then. Nor now.
Remember the House bill still must get through the Senate and that body is as divided as the House. But one difference is that there is a constituency in the Senate for Medicaid. (As I have been writing: This is the most significant impact on Indian Country. This bill doesn’t just repeal the Affordable Care Act, it ends Medicaid as we know it. Medicaid insures more than half of all children in the Indian Health system and it accounts for 13 percent of the Indian Health Service budget.)
At least four Republican Senators, Rob Portman (Ohio), Shelley Moore Capito (West Virginia), Cory Gardner (Colorado), and Lisa Murkowski (Alaska) have been clear about their support for Medicaid and Medicaid expansion. (Medicaid is a state, federal partnership to provide health care for families with low incomes. The Affordable Care Act expanded that to single people and lowered the income limits to 138 percent of federal poverty guidelines. The numbers are huge. Before the ACA about 56 million people were insured by Medicaid. Today the number is nearly 75 million.)
A bloc of four senators — if they don’t budge — has the power to say “no” to any legislation. This is the Medicaid Protection Block. And Republicans only have two votes to spare in the Senate because all of the Democrats will likely oppose this measure (as they did in the House). So the thing is that if the Senate language satisfies theMedicaid Protection Block that will enrage the Freedom Caucus in the House. That bloc stuck together and killed the House’s first version of the legislation, so the second version was even more to their liking (removing federal requirements to provide basic health services including pre-existing conditions).
Complicated, right? Add to that mix the conservative members of the Senate who don’t think this bill goes far enough in the outright repeal of the Affordable Care Act. Sen. Paul Rand (Kentucky) said on Fox News: “It will take a little bit of work to get me to ‘yes’ vote on health care bill.” In other words make the bill more ideological, not something that will get support from the Medicaid Protection Bloc.
And if that’s not complicated enough, there are also Republicans in the Senate that object to the bill’s attack on Planned Parenthood because of the impact of such a policy on women’s health. That bloc includes Murkowski and Maine’s Susan Collins.
Complex or not, no matter what comes out of the Senate (unless it’s the House bill exactly) the House will have to vote again. Then the illogical Freedom Caucus gets another shot at defying their own party leadership.
But the real politics of Wednesday’s action is not in Congress. It’s playing out on social media and communities across the country. It’s the idea that this vote was a definition for the next election. One side believes that health care is not a right. The other sees the Affordable Care Act as imperfect, but a step in the right direction.
Indian Country should be included in this debate. And we’re not. Our right to health care is simple, it’s based on treaties, history, and thus a pre-payment for whatever insurance mechanism the country comes up with. The Affordable Care Act at least opens up an avenue to fully fund the Indian Health system something that’s never been accomplished before.
This is also the ideal moment for Indian Country to have more of a say. This is when a political coalition can be built around idea that health care is a right. Health care is already defining the 2018 elections.
And the politics of that start in Red states (those that voted for President Donald J. Trump). This bill, in a quest for free market purity (if that’s even possible in health care), would benefit young people, healthy people, and people who live in cities. And paying for that experiment are older people, sicker people, and rural people.
Alaska is at the top of this list. The Affordable Care Act pays insurance companies to help keep costs down. The Republican plan ends that business. The result: “Consumers in 11 states would see tax credits fall by more than $3,000 on average, or more than 50 percent, and consumers in seven states would lose an average of more than $4,000. In Alaska, by far the highest-premium state, the average reduction in tax credits would be $10,200, or 78 percent,” according to a study by the Center for Budget and Policy Priorities.
And that doesn’t even include Medicaid. Another study on that issue found the program saved Alaska significant dollars, projecting a billion dollar return after a decade. The state’s Commissioner of the Department of Health and Social Services, Valerie Davidson, told KTUU News that “with our $3.5 billion budget deficit, we don’t have an additional one billion dollars more to pay for services that we currently have, we just can’t afford it.”
She also said the House bill would strip behavioral health funding when it’s so important in the middle of an opioid epidemic.
So for an Alaska representative, one that works for constituents, this should have been a no-brainer. This bill is terrible for Alaska. Last week Rep. Don Young said as much. He claimed victory when the previous bill was pulled from consideration without a vote. He told The Alaska Dispatch News: “My job is to represent those people in that state, and I think we did this this week. I work with (House Speaker Paul Ryan), don’t get me wrong — the speaker talked to me quite a bit. But it didn’t come to a point where I could support this bill. He needed my vote.”
The bill that passed Wednesday is not significantly different. Alaska is still hosed. And Don Young voted “yes.” Now he says, don’t worry, this bill will not become law. The Senate will change it.
That’s basically the position of Rep. Tom Cole, a Republican in leadership, and a member of the Chickasaw Nation. He told National Public Radio: “This thing is going to go to the United States Senate. It’s going to change, in my view, in the United States Senate in some way. Then we have to have a Congress — a conference to work out the differences. If we can do that, then it has to still pass the House and the Senate again before it ever gets to the president. So, you know, at some point, you just have to move. And we think this is it and that this will create some momentum. Again, I’m interested to see what our friends in the Senate will do in response.”
Cole is a champion for Indian health programs, especially when it comes to the budget. He’s often the critical voice and the only Native American at the table when budgets are written. However he dismisses Medicaid Expansion quickly because Oklahoma is one of the states that’s passed. Ok. We disagree. Understandable.
But this House measure is not just about Medicaid Expansion; it’s a radical restructuring of Medicaid and capping costs. Even in Oklahoma Medicaid serves more than 800,000 people. And, remember that Medicaid is 13 percent of the IHS budget, more than $800 million now and growing. Already more than half of our children are insured this way. Plus this is the best kind of money because it’s used by local clinics and hospitals.
This is what Tom Cole, Don Young, and 215 other Republicans voted to take away from Indian Country. This is what’s on the ballot next year.
How much does it cost to buy the vote of a ‘moderate’ Republican? Today the going rate is $8 billion. (And that, by the way, is more than ten times amount of money the Indian health system is at risk of losing if Congress enacts the “American Health Care Act.”)
The $8 billion would fund a high-risk pool for individuals with pre-existing conditions. The idea surfaced Wednesday as an amendment from so-called moderate Reps. Fred Upton of Michigan and Billy Long of Missouri after a meeting with President Donald J. Trump. This pool of funds is supposed to make it easier to take away a requirement in the current law to cover pre-existing conditions. Upton is quoted by The Hill newspaper saying, “I think it is likely now to pass the House.”
Here’s the thing. An $8 billion pool won’t come anywhere close to meeting the need.
Just think about this: Chronic care, including diseases such as heart disease and diabetes, consume nearly nine-out-of-ten health care dollars (which totaled $2.9 trillion in 2013). Add to that cancer and other costly diseases and it’c clear that $8 billion is not even a down payment.
But as I have been reporting: “The bill would still wipe out Medicaid as we know it. Medicaid represents 13 percent of the Indian Health Service budget (or $808 million).” Indian Country’s biggest concern right now ought to be Medicaid, Medicaid and Medicaid. There are now 30 million children covered by Medicaid; more than half of all Native children.
The last version of the bill sticks with its revision of Medicaid by capping the costs.
The crazy part of this equation is “why?” The Senate is not going to pass this bill. Several Republican Senators, including Alaska’s Lisa Murkowski, have said they support Medicaid as a state decision. This bill will, however, put House Republicans on the record. Alaska’s Rep. Don Young has been listed throughout this process as an undecided or a “lean no.” No other state will lose as much in this legislation as Alaska. So the choice will be a vote for the party or one for constituents.
The revised bill is expected to move to the House floor as soon as today. This legislation is moving so fast that few will have a chance to review it. And the Congressional Budget Office will not be able to look at the bill’s impact on either the budget or on American’s access to insurance. — Mark Trahant
Debra Haaland filed paperwork to run for Congress from New Mexico. If elected, she would be the first Native American woman to ever serve in that body. And what makes this news especially cool: This is a winnable seat.
Haaland, a member of Laguna Pueblo, has served the past two years as the state’s Democratic Party chair (where she successfully retired the party’s debts). She has also been a candidate for lieutenant governor and chaired the Laguna Development Corporation and has been a tribal administrator. Her Twitter profile says: “A proud UNM Lobo mom; Pueblo woman; Marathon runner; Gourmet cook.” She also tweeted: “Thank you for the outpouring of support! Stay tuned for more in the coming weeks … and is using the hashtag, #Deb4Congress and her web site is found at debforcongress.com.
“I’ve spent my life advocating for the underrepresented, advancing progressive values, and working tirelessly to help elect Democrats up and down the ballot,” Haaland said in a statement. “I want to ensure that everyone’s voice is heard, and it would be an honor to be that voice for our communities, our families, and for all of us.”
New Mexico’s First Congressional District includes Albuquerque and the north-central portion of the state. It’s currently represented by Michelle Lujan Grisham, a Democrat, who won with 65 percent of the vote and is now running for governor. The seat is rated “solid” or “safe” for the Democrats by several political reports.
Since this will be an “open” seat there will be a lot of competition. So the test for Haaland will be a primary election in June of next year. That means she will need early campaign money. Rep. Grisham raised $1.8 million for her re-election in 2016, however, the last time a Republican held this seat, former Rep. Heather Wilson, she raised and spent nearly $5 million.
As a former party chair, Haaland should be well-suited to take on the fundraising challenges. She has basically been raising money — albeit for others — for the past two years. She was the first Native American woman to serve as the party chair.
Congress has a spending plan. And it rejects most (but not all) of President Donald J. Trump’s priorities. It also includes more money for most federal Indian programs.
But remember: This is a short budget. It’s only enough money to fund government operations through the end of September.
House Appropriations Chairman Rodney Frelinghuysen (R-NJ) said: “This package of the remaining Appropriations bills is the result of over a year’s worth of careful and dedicated efforts to closely examine federal programs to make the best possible use of every tax dollar. This legislation will fund critical federal government activities, including our national defense, and enact responsible funding decisions to target U.S. investments where they are needed the most. It also maintains and enhances policies that bolster economic growth and support the core values that our nation is built upon.”
About a week ago I wrote that the best option for Congress was for “the White House to work with Democrats and spend money on their priorities. It’s the basic formula that has led to enactments of budgets for the past 8 years. The bargain would mean continued spending for domestic programs as well as add money to the military. The wall? No. Cutting support for Planned Parenthood? Get serious. And health care funding? That’s why it’s called the art of the deal.”
That’s essentially what happened. But it wasn’t the White House. It was Republican leaders in Congress that did the deal. The military budget increased $25 billion over current levels. There was also an additional $1.5 billion for border security.
Both the Bureau of Indian Affairs and the Indian Health Service will get a slight boost from this budget.
American Indian and Alaska Native Programs – The Bureaus of Indian Affairs and Education are funded at $2.9 billion – an increase of $69 million above fiscal year 2016. This includes necessary increases for schools, law enforcement, road maintenance, and economic development.
The Indian Health Service is funded at $5.0 billion – an increase of $232 million above the fiscal year 2016 enacted level. This includes operating costs for staffing at new facilities, and increases for rising contract support costs, medical inflation, and a growing and aging population.
But the Environmental Protection Agency takes a hit. “The bill funds the EPA at $8.06 billion, a reduction of $81.4 million below the fiscal year 2016 enacted level and $209 million below President Obama’s budget request,” the Committee said. “Within this total, the EPA’s research and regulatory programs are reduced by $52 million below the current level and over $300 million below the previous administration’s request.”
However the bill will add $75 million to speed up Superfund cleanup projects.
The fight over the National Endowments for the Arts and Humanities is saved for another day too, the bill includes $150 million for each of the endowments, $2 million above the fiscal year 2016 level. A similar story for the Corporation for Public Broadcast. The bill includes an advance appropriation of $445 million for CPB for fiscal year 2019, which is the same level of advance funding provided in the fiscal year 2016 enacted level and the previous Administration’s budget request.
Another White House budget item for next year — cutting funding for the Violence Against Women Act — is also a no go in this budget. The House committee says “funds are increased within the highest-priority grant programs, including $481.5 million for the Violence Against Women programs and $403 million for Byrne Justice Assistance Grants.”
Congress must still vote on the spending bill. But the prospects are strong because Democrats are on board so it only takes a handful of Republicans to make it law.