Fair to say this budget will result in the early death of too many people
Mark Trahant / Trahant Reports
It’s easy to blame Donald J. Trump for a terrible budget. This is classic disruption; it’s designed to change the nature of government immediately. It’s also a destructive document that would result in great hardship across the nation and Indian Country. It’s not too strong to say that this plan would mean an early death for too many people.
So we ignore what’s proposed and turn to Congress for the real spending plan. The idea is that Congress will do something better. They must. Or face the consequences from voters in the 2018 elections. And it’s already clear that few Republicans are eager to reshape government (at least as dramatically as the president.) It’s unlikely that Congress will vote to eliminate agencies ranging from the Corporation for Public Broadcast to the Denali Commission. And the minus signs inked across budget lines will be less severe than requested.
But let’s be clear: The best outcome is probably another Continuing Resolution that patches together a temporary budget for a few months or possibly the entire year. Again. That’s become business as usual in Washington.
The ‘worse’ news: A failure to govern
That’s the good news. The bad news — strike that — make it the worse news is that neither political party has enough support to enact a thoughtful spending plan. The crisis is not a financial one (well, it is sort of) but represents a systemic failure to govern.
The best example of that problem is the debt ceiling. Basically it’s a law that allows the Secretary of Treasury to finance the debt that the United States already owes. The money has already been appropriated or authorized by Congress. It’s spent. So the only question is to pay the bill or not. Yet nearly every member of Congress (from the Tea Party to Sen. Barack Obama) bluster about the debt and threaten to withhold their vote. But the party in the White House cannot operate that way. Obama changed his tune as quickly as did Trump. It’s the nature of the job.
Congress isn’t run by two political parties; there are at least three major factions. (This is not unusual: Just before the Civil War the Republican Party was deeply divided by economic conservatives and the Radical Republicans who were organized against slavery.) Today’s Congress is composed of Republicans, the more strident House Freedom Caucus, and the Democrats.
It will take votes from two of the three factions to lift the debt ceiling and pass a budget in the House. This is important because the first “test” of a coalition was the vote to repeal the Affordable Care Act and replace it with the American Health Care Act. The moderate Republicans sided with the House Freedom Caucus to pass a measure that would strip insurance coverage from 23 million Americans (according to the Congressional Budget Office). You’d think this would be nonsense politics for Republican moderates. Yet they still voted yes. The thing here is that this is the coalition to watch. So if Speaker Paul Ryan goes that route again it will mean a debt ceiling bill that results in even more spending cuts than the Trump budget. Imagine that.
The other alternative is just as unthinkable. It’s for Ryan to reach out to Democrats and build a majority coalition. This happens in state capitals all the time. But it’s considered near treason in politics and it would cost Ryan his job. Beyond that, the votes of the Democrats would come with a price, most likely a promise not to cut taxes on the wealthy.
Then whatever spending bill that emerges from the House must win 60 votes in the Senate. That’s not going to happen if the House Freedom Caucus wins the day. (Remember there are currently 52 Republicans, 46 Democrats and 2 independents in the Senate).
This is real juggling. Debt. Budget. And health care. And the Juggler-in-Chief doesn’t even like balls in the air. He tweeted last month: “Our Country needs a good ‘shutdown’ in September to fix mess!”
A federal government that’s ‘ineffective’
Back to the budget and what it means for Indian Country.
The same division in Congress over the debt ceiling (or health care) will play out on the budget. The House Freedom Caucus essentially agrees with the president’s budget. If there’s any reluctance … it’s that the spending cuts are not deep enough. The argue that the federal budget must be balanced in a decade and it will take painful cuts to reach that goal. (So the other Republicans, such as Rep. Tom Cole, will need to find votes for their moderate course from Democrats to reach a legislative majority).
The tension over national spending priorities, historically, has impacted federal Indian policy before.
President Franklin D. Roosevelt initially sharply cut federal Indian programs as part of an austerity drive.
In the late 1920s and early 1930s spending by the Bureau of Indian Affairs doubled from 1928 to 1932 (following the publication of the Meriam Report about the failure of federal programs and declining health, education and just about social indicator for Native Americans. “Several past policies adopted by the government in dealing with the Indians have been of a type which, if long continued, would tend to pauperize any race,” the report said, calling the government’s efforts “ineffective.” But Hoover’s 1933 budget reversed that progress and cut the Bureau of Indian Affairs budget by 15 percent, dropping from $25.6 million to $22.1 million. Then a year later, in 1934, dropped another 13 percent to $18.7 million.
But it was Congress — not the president — that was stingy. But at a public hearing in 1938 tribal leaders from Wisconsin, Minnesota and Michigan complained about the “resistance of the government itself against any increased appropriations.”
However after the passage of the Indian Reorganization Act in 1934 spending did pick up and budgets increased.
After World War II the government again sharply cut spending in Indian Country. The 1948 budget declined by 9 percent, but that turned out to be a one-time hit. A year later the budget increased by more than 50 percent, to $62.1 million.
The figures were similar after President Richard Nixon announced the new policy of self-determination without termination on July 8, 1970. Nixon said, “we must begin to act on the basis of what the Indians themselves have long been telling us. The time has come to break decisively with the past and to create the conditions for a new era in which the Indian future is determined by Indian acts and Indian decisions.”
And the BIA’s budget reflected that idea. The budget increased by 18.5 percent in 1971, another 19 percent in 1972, and 23 percent in 1973.
But Nixon, like many Republicans, separates federal spending on the Bureau of Indian Affairs and the Indian Health Service from other programs that benefits Native people. President Lyndon B. Johnson’s Great Society programs such as the Office of Economic Opportunity opened up new channels for tribal innovation. For the first time tribal leaders were managing significant budgets without the Bureau of Indian Affairs. The agency’s director wrote Congress in 1974 that OEO was ineffective and an “old approach” that did not serve the poor.
This is a pattern that continues today. Many mainstream Republicans are supportive of appropriations for the Bureau of Indian Affairs or the Indian Health Service, but less so for other general programs that benefit Indian Country, such as the Comprehensive Employment and Training Act (signed into law by Nixon but ended by Ronald Reagan.)
A twist here: My first professional job as editor of The Sho-Ban News was funded by CETA in 1976. Tribes could use the money to create jobs — even at a tribal newspaper. And did so.
I had moved to Washington, D.C., before Ronald Reagan was elected in 1980 and he, like Trump, promised sharp cuts across the federal government. One plan was floated that would cut social programs by a third (shifting some of the money to states as block grants).
But Congress was on the other side of this equation and mostly ignored the president’s requests.
Yvette Joseph, Colville, who was working for the Senate Committee on Indian Affairs, compared the budget on Indian programs from 1968-1988 to similar government programs and found significant underfunding. She wrote: “Gwen Ifil did a story on my research when she worked for the Washington Post. It made it on the front page of the newspaper and was the impetus for Senator Dan Inouye seeking a billion dollar increase to the Indian Budget because we could show how significantly, the federal Indian budget had been been reduced under Ronald Reagan’s zero-sum budget policies. That year, we did not reach our goal, but were in fact able to increase the American Indian / Alaska Native budget by $750 million in FY 1989. It was amazing to be a part of this work.”
Obama is the exception to the rule
The Obama era is another exception, and on the upside. As former Assistant Secretary for Indian Affairs Kevin Washburn wrote in Indian Country Today: “In his first term, Obama increased the Indian Health Service budget by more than $800 million and steadily increased IHS funding by more than $1.2 billion, reaching $4.8 billion in total. Obama’s second term began inauspiciously with sequestration imposed by Congress in 2013, but the Indian Affairs budget at Interior for the Bureau of Indian Affairs and the Bureau of Indian Education nevertheless increased from approximately $2.3 billion to $2.8 billion before Obama left office, an increase of a half-billion dollars. These increases significantly outpaced inflation and produced real and significant gains for Indian country.”
Beyond that top-line there was another potentially significant action that’s being debated again: The Affordable Care Act. This law opened a door for the full-funding of the Indian Health Service because it recognized that health care delivery and insurance are not the same thing. So if more American Indians and Alaska Nations could bring insurance to their federal, tribal, or not-for-profit clinic, it could add significant resources to the entire system. It did this by expanding Medicaid, requiring tribal employees to have insurance, and by setting up a free insurance plan under the ACA. I think a lot more could have been done to promote this idea, but it’s all at risk now anyway. But it’s important to note that Medicaid works — especially in Indian Country. (I will be writing more about that next week as health care debate moves to the Senate). More than half of our children are now covered by that public insurance. And we still have thousands of people who are eligible but who have not yet signed up.
Medicaid is an entitlement. That is different from appropriations because Congress does not have to act for the money to be there. (Which is exactly why the Republicans want it to go away by changing the law.) Medicaid was the most successful part of the Affordable Care Act, both in Indian Country, and among the general population. Yet the House plan would cut spending by $834 billion over ten years and shift more of the cost of public health insurance to the states (leaving huge questions about where American Indian and Alaska Natives fit in).
Ok. Stay with me here. This will be complicated. Much of the budget cuts — including those that would impact Indian Country — are taken from the smallest part of the budget, domestic discretionary. All safety net programs (except for health and social security) total about 10 percent of the budget. The big bucks are found at Social Security (33 percent); Medicare, Medicaid, Children’s Health Insurance Program, and marketplace subsidies together total about 28 percent of the budget. Defense is 16 percent of the budget and Veterans programs at about 4 percent. And interest on the debt is 7 percent (thanks to low interest rates). But expect that category to grow as interest rates increase.
Domestic spending (except for health) has been declining since 2010. Depending on the final numbers in Trump’s budget, it’s likely that spending will drop to less than what was spent on 1962 on such programs. Before the Great Society. This is the part of the budget that includes Indian Country programs.
The point here is that the Congress could zero out domestic spending and there still would be a deficit.
The bigger problem is demographic. Two trends to consider. First the sheer size of the Baby Boom generation. And, second, humans are living longer than ever before. As Pew Research points out “about 10,000 Baby Boomers are retiring every single day, many of them not as well prepared financially as they’d hoped. The graying of our population will put stresses on our social safety net and present our elected leaders with a daunting challenge: how to keep faith with the old without bankrupting the young.”
Medicaid is a great example of this divide. Most of the news stories (including mine) focus on the health care aspects of this great program. Yet two-thirds of Medicaid — nearly $400 billion — is spent on the elderly and the disabled. About 60 percent of nursing home residents are supported by Medicaid and it’s the only program for seniors and for people with disabilities that pays for long-term care. Our discourse and the debate seems to ignore that.
Then our elders in Congress aren’t any better than those of us who write. Consider the illogic of the House Republican budget: It protects Social Security but it could wipe out funding for the older Americans who live in nursing homes. That same budget proposal cuts Medicaid for the poor both adults and children, but protects Medicare for those 65 years and older.
So who, exactly, are the constituents? (The only answer that is consistent: Tax cuts for the wealthy. That’s the point of the GOP health care plan.)
Also from Pew: “Today’s Millennials – well-educated, tech savvy, and underemployed – are at risk of becoming the first generation in American history to have a lower standard of living than their parents.” (It’s worth noting that young people in the United Kingdom turned out in record numbers and one of their top concerns was “austerity.”)
To be fair, Democrats haven’t come to grips with the cost side of this equation. There are just not enough taxes to pay for the growth of Medicare and Medicaid unless there is also a significant restructuring of the health care system. Still. The Affordable Care Act was just a start. A baby step at that. Get this: The Indian Health system is more in line with a health care system should cost than what is spent by the rest of the country. The gap that we so often complain about must be the country’s future. (As a reminder: According to the National Congress of American Indians, In 2014, the IHS per capita expenditures for patient health services were just $3,107, compared to $8,097 per person for health care spending nationally.)
So, yes, eventually, that means a single payer system of some kind. Sooner would be better than later. There is no other way to make the budget work.
Neither the Congress nor the White House is ready to take on these big issues. It’s much easier to cut smaller programs that matter to people, again, like those that serve Indian Country, and think the task is complete. It’s not.
So while it’s easy to blame the president for a terrible budget. The problem is much worse. And the solutions remain distant. The government is failing.
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
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