Mark Trahant / Trahant Reports
Big news: The rest of the year will have less drama than the ups and downs we’ve been experiencing since January. The federal government will more or less operate on schedule, the federal debt limit fight has been pushed back to the end of the year, and President Donald J. Trump has successfully reached out to Democrats.
What a week. When it began, I wrote: “Congress is back today and one of two things will happen: It will either do its work or all hell will break loose.” But I was off. It wasn’t exactly Congress doing its job, it was the president. He bypassed his own Republican party leaders (catching them off-guard by all accounts) and struck a deal with Democrats in the House and Senate to fund government for the rest of the year and push the debt limit fight back until December.
This is exactly what the president should have been doing all along. This is governing. It means, for now, at least, that he’s reaching out to the majority in Congress (moderate Republicans plus the Democrats) instead of catering to the far right wing of the party. It’s smart politics. But it’s also dangerous because his action undermined both House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell. If it’s a one-time event, Ryan and McConnell will get over the snub. But if this is the new way of doing business, well, then, there will be a different kind of drama ahead.
There is also movement this week on the Republican plans to repeal and replace the Affordable Care Act. According to The Hill newspaper, John McCain now favors legislation proposed by Senators Lindsey Graham, R-South Carolina, and Bill Cassidy, R-Louisiana. This plan would push more of the decision making about health care to the states through block grants. It would even let states keep many aspects of the Affordable Care Act such as Medicaid expansion, as long as they’re willing to pay for the extra costs. That’s a deal breaker.
The problem for the Indian health system in such a scheme is that states neither understand nor want to invest the resources required. The ideal scenario would be for Indian Country to be a 51st state and get funding directly. But that’s not a part of the legislative proposal.
This bill would have to be considered fast under Senate rules. The current set-up is to vote on a replacement plan using the budget reconciliation process. That only requires 50 votes instead of the more common 60 vote standard (to interrupt a filibuster). The Senate parliamentarian has ruled that reconciliation goes away on Sept. 30 unless there is a new budget in place. That’s unlikely.
Another health care issue that impacts Indian Country is the reauthorization of the Children’s Health Insurance Plan or CHIP. The current law expires Sept. 30. It pays for the insurance of 8.9 million children through Medicaid. The Kaiser Family Foundation reports that “Medicaid plays a more expansive role for American Indian and Alaska Native children than adults, covering more than half of American Indian and Alaska Native children (54%) versus 23% of nonelderly adults.” CHIP would be included in that number.
CHIP also pays for school programs and other health care outreach efforts. The federal Centers for Medicaid and Medicare said: “In 2014, CMS awarded $3.9 million in CHIPRA grants to engage schools and tribal agencies in Medicaid and CHIP outreach and enrollment activities. Grantees included Indian Health Service organizations, tribal health providers, and urban Indian health providers across 7 states.”
Important stuff. We need another presidential deal with Democrats. Quickly.
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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