Agency Says Indian Health Should Not Be Exempt From Medicaid Work Rules Because They Are ‘Race-Based’
Mark Trahant / Trahant Reports
The Trump administration is supporting a major policy shift on Indian health programs which could result in a loss of millions of dollars and sabotage treaty rights.
A story in Politico Sunday raised the issue. It said “the Trump administration contends the tribes are a race rather than separate governments, and exempting them from Medicaid work rules — which have been approved in three states and are being sought by at least 10 others — would be illegal preferential treatment. ‘HHS believes that such an exemption would raise constitutional and federal civil rights law concerns,’ according to a review by administration lawyers,” Politico said.
The new policy on Medicaid work requirements “does not honor the duty of the federal government to uphold the government-to-government relationship and recognize the political status enshrined in the Constitution, treaties, federal statutes, and other federal laws, said Jacqueline Pata, executive director of the National Congress of American Indians. “Our political relationship is not based upon race.”
“The United States has a legal responsibility to provide health care to Native Americans,” Mary Smith, who was acting head of the Indian Health Service during the Obama administration and is a member of the Cherokee Nation, told Politico. “It’s the largest prepaid health system in the world — they’ve paid through land and massacres — and now you’re going to take away health care and add a work requirement?”
Medicaid has become a key funding stream for the Indian health system — especially in programs managed by tribes and non-profits. Medicaid is a state-federal partnership and public insurance. The Affordable Care Act expanded Medicaid eligibility, but the Supreme Court ruled that each state could decide whether or not to expand. Since the expansion of Medicaid some 237,000 American Indians and Alaska Natives in 19 states have become insured.
Officially Medicaid represents 13 percent of the Indian Health Service’s $6.1 billion budget (just under $800 million).
But even that number is misleading because it does not include money collected from third-party billing from tribal and non-profit organizations. In Alaska, for example, the entire Alaska Native health system is operated by tribes or tribal organizations and the state says 40 percent of its $1.8 billion Medicaid budget is spent on Alaska Native patients. That one state approaches the entire “budgeted” amount for Medicaid.
Other states report similar increases. Kaiser Family Foundation found that in Arizona, one tribally-operated health system reported that about half of visits were by patients covered by Medicaid in 2016. And, an Urban Indian Health Program, reported that its uninsured rate at one clinic fell from 85 percent before the Affordable Care Act to under 10 percent.
Those Medicaid (and all insurance) dollars are even more significant because by law they remain with local service units where the patient is treated (and the insurance is billed). In Alaska more than two-thirds of those dollars are spent on private sector doctors and hospitals through purchased care for Alaska Native patients. And, unlike IHS funds, Medicaid is an entitlement. So if a person is eligible, the money follows.
A recent report by Kaiser Health News looked at Census data and found that 52 percent of residents in New Mexico’s McKinley County have coverage through the Medicaid. That’s the highest rate among U.S. counties with at least 65,000 people. “The heavy concentration of Medicaid in this high-altitude desert is a result of two factors: the high poverty rate and the Indian Health Service’s relentless work to enroll patients in the program,” Kaiser reported. Most of McKinley County is located on the Navajo and Zuni reservations.
Kaiser Health News said Medicaid has opened up new opportunities for Native patients to “get more timely care, especially surgery and mental health services. It has been vital in combating high rates of obesity, teen birth, suicide and diabetes, according to local health officials.”
However the growth of Medicaid is resulting in unequal care for patients in the Indian health system. The benefits in some states, including those that expanded Medicaid under the Affordable Care Act, are more generous. Other states not only refused to expand Medicaid and have been adding new restrictions such as requiring “able-bodied” adults to have their Medicaid eligibility contingent on work.
But the Indian health system — the federal Indian Health Service and tribally and nonprofit operated programs — are in a special case because there is a 100 percent federal match for most services. So states set the rules, but do not have to pay the bill. (Medicaid is often the second largest single item in a state budget behind public schools.)
Medicaid is the largest health insurance program in America, insuring one in five adults, and many with complex and long-term chronic care needs. The Trump administration and many state legislatures controlled by Republicans see Medicaid as a welfare program. While most Democrats view it simply as a public health insurance program.
Work rules are particularly challenging for Indian Country. Unlike other Medicaid programs, patients in the Indian health system will still be eligible to receive basic care. So stricter rules will mean fewer people will sign up for Medicaid and the Indian Health Service — already significantly underfunded — will have to pick up the extra costs from existing appropriations. That will result in less money, and fewer healthcare services, across the board.
A letter from the Tribal Technical Advisory Group for Medicare and Medicaid said American Indians and Alaska Natives “are among the nation’s most vulnerable populations, and rely heavily on the IHS for health care. However, the IHS is currently funded at around 60 percent of need, and average per capita spending for IHS patients is only $3,688.” The latest per person cost for health care nationally is $10,348 (totalling $3.3 trillion, nearly 20 percent of the entire economy).
The tribal advisory group said it is “critically important” that there be a blanket exemption for IHS beneficiaries from the mandatory work requirements.
A report in September by the Kaiser Family Foundation showed that the majority of American Indians and Alaska Natives on Medicaid already work, yet continue to face high rates of poverty. It said over three-quarters of American Indians and Alaska Natives are in working families, but that’s a gap of about 8 percent compared to other Americans (83 percent).
The Trump administration’s characterization of tribal health programs as “race-based” is particularly troubling to tribal leaders because it would reverse historical precedence.
A memo last month from the law firm of Hobbs, Straus, Dean & Walker said the Centers for Medicare and Medicaid Services “has ample legal authority to single out IHS beneficiaries for special treatment in administering the statutes under its jurisdiction if doing so is rationally related to its unique trust responsibility to Indians. Under familiar principles of Indian law, such actions are political in nature, and as a result do not constitute prohibited race based classifications. This principle has been recognized and repeatedly reaffirmed by the Supreme Court and every Circuit Court of Appeals that has considered it, and has been extended to the actions of Administrative Agencies like the Department of Health and Human Services even in the absence of a specific statute.”
Mark Trahant is editor of Indian Country Today. He is a Shoshone-Bannock tribal citzen. On Twitter: @TrahantReports Cross posted on Indian Country Today.
(The National Congress of American Indians is the owner of Indian Country Today and manages its business operations. The Indian Country Today editorial team operates independently as a digital journalism enterprise.)
Many years ago Richard LaCourse and I would sit around and toss ideas about what the perfect Indigenous newspaper would look like. LaCourse, at the time, was trying to create a new publication in Washington, DC.
Imagination was his currency. What was possible?
LaCourse had a lot of experience answering that question. He had helped build the American Indian Press Association. He had edited or written for several tribal newspapers, including his own, The Yakama Nation Review. He launched a one-person crusade to raise the standards of Native American journalism.
I even remember the first time I heard him do that. It was on Feb. 24, 1977, at a workshop in Spokane. A workshop speaker was telling tribal editors that they worked for tribal councils and should slant the news accordingly. LaCourse stood up. Angry. Shaking his finger. “Are you aware of the 1968 law that guarantees freedom of the press in Indian Country? Indian newspapers should be professional, straight reporting operations, and your assumptions about cheerleaders for a point of view has nothing do do with the field of journalism. Why are you making this presumption?”
I am thinking of Richard LaCourse as we begin Indian Country Today’s third chapter. The goal is to build on the legacy of LaCourse—as well as from the first two chapters of Indian Country Today. The publication was founded by Tim Giago in South Dakota in 1991 and was followed by the ownership of the Oneida Nation of New York.
It’s hard to think of a better word than legacy, actually. The word is from the 14th century Latin legatus, an ambassador, envoy, a deputy sent with a commission. A century later the word had shifted and become associated with property, a gift. Both definitions fit. The gift is all of the work done before. The commission is the tasks ahead.
Indian Country Today is now owned by the National Congress of American Indians—but we will act independently. We are creating a framework to ensure that. But our primary task is the same as LaCourse’s vision: Professional, straight reporting that tells stories about Indigenous people and our nations.
I’d like to thank the National Congress of American Indians(NCAI) for engaging in this experiment. It would have been easy to say, “well, no.” Especially when the challenges of independence are factored into that equation.
The NCAI has a long history of working with the Native press (even while our missions are different.) One of the great journalists of her generation, Marie Potts, a Maidu, and editor of California’s Smoke Signals best writing in Washington while on working on a fellowship with NCAI during the late 1960s.
The best way I know how to demonstrate our independence is to produce solid, thoughtful journalism. Every day. So there is a lot of hard work ahead. (And we will need some time to make this so.)
What does this mean for Trahant Reports? For the time being I will cross post on Trahant Reports and Indian Country Today sites. I have a lot of material I am working on for the elections ahead, Indian health, and other policy issues. So more, not less.
And Indian Country Today is back in business and we are ready to serve.
Our goal is to hire a team in Washington, create (and fund) reporting fellowships around the country, and build capacity for freelance contributors. We want to be partners, not competitors, with tribal newspapers, public media, and web publishers.
I have been teaching journalism for the past seven years and I am always telling students that this is a time of great opportunity. The digital world means that we can reach our audiences instantly. We can communicate ideas. We can explain a complicated process. We can expose wrongdoing. Or write a story about pop culture that makes us smile.
We can invent a new kind of news organization, one that trades on the currency of imagination.
Mark Trahant is editor of Indian Country Today. On Twitter: @TrahantReports
The Trump administration, and its allies in Congress, are fighting a losing war. They continue to press forward for the development of oil, gas, coal, when the rest of the world understands the implication of that folly. Global warming is the most pressing issue for our time. Period.
The thing is governments really have two choices when it comes to managing the impact on its peoples from global warming: Spend money on trying to reduce the problem; or spend money on cleaning up the catastrophes.
I witnessed first hand the impact of Hurricane Maria on the island of Dominica last month. We keep hearing stories about the power grid being down (similar to Puerto Rico) and you think, why? It’s been months. Why aren’t the lights on? Then you see nearly every electrical pole on the island sideways. The entire grid needs to be rebuilt (or better, rethought) and that’s decades of infrastructure. So the figure of $1.5 trillion is far short of what will be needed. Nearly every electrical line, every other house, the damage was so widespread it’s impossible to overstate. And that’s just one island. Multiple the effect across the region. The planet.
Even the United States.
The Centers for Environmental Information says there were sixteen weather and climate disasters with losses exceeding $1 billion each across the country last year. These events included one drought, two flooding events, one severe freeze, eight severe storms, three cyclones, and one extraordinary wildfire. These “events” as the center defines them resulted in 362 deaths.
Turns out 2017 was a record-breaking year. “In total, the U.S. was impacted by 16 separate billion-dollar disaster events tying 2011 for the record number of billion-dollar disasters for an entire calendar year,” the report said. “In fact, 2017 arguably has more events than 2011 given that our analysis traditionally counts all U.S. billion-dollar wildfires, as regional-scale, seasonal events, not as multiple isolated events.More notable than the high frequency of these events is the cumulative cost, which exceeds $300 billion in 2017 — a new U.S. annual record.”
A similar report was published by the Government Accountability Office including a recommendation that Executive Office of the President “identify significant climate risks and craft appropriate federal responses.”
But instead of trying to reduce the impact — and the costs of weather-related catastrophe — the Trump administration continues on course for new development of oil and gas. The Interior Department announced new rules that, if enacted, will open up nearly all of the United States coastal waters to more oil and gas development beginning next year.
“By proposing to open up nearly the entire OCS for potential oil and gas exploration, the United States can advance the goal of moving from aspiring for energy independence to attaining energy dominance,” said Vincent DeVito, Counselor for Energy Policy at Interior in the news release. “This decision could bring unprecedented access to America’s extensive offshore oil and gas resources and allows us to better compete with other oil-rich nations.”
Or as Interior Secretary Ryan Zinke put it: “The important thing is we strike the right balance to protect our coasts and people while still powering America and achieving American Energy Dominance.”
Dominance is such a funny word. How can any nation be dominant in the face of hurricanes that are ever more powerful and destructive? How does energy dominance work when tens of thousands of Americans will have to move because their homes are no longer there because of fire or storms? What happens if that number grows into the hundreds of thousands? Millions? How can we afford to spend trillions of dollars rebuilding what we have now?
A group of elders on the Bering Sea immediately condemned the Interior Department’s offshore drilling plan. “We told them that in person last October and again in writing, that there were 76 tribes in these regions opposed to this,” said the statement from the elders. “The draft plan implies that Bering Sea communities were ‘generally supportive of some’ oil and gas activity. This is not accurate and there is no evidence of this from Bering Sea communities. For decades, our people have opposed oil and gas activity and we continue to oppose it today. The northern Bering Sea is a very fragile ecosystem. The marine mammals that we rely on use it as their highway and they follow specific migration routes. That is how we know when and where to find them. The noise and vibration associated with drilling will interfere with their sonar and disrupt their migrations. Then we the coastal people will lose our primary food source.”
There is a connection between developing oil and gas and paying the high costs to clean up after a storm. One side of the ledger goes to a few; the oil and gas “industry.” The folks who bought and paid for this administration.
The other side of the ledger is the rest of us. The taxpayers who will foot the bill for this continued folly.
And on the Bering Sea? The folks who live there are one storm away from a tragedy. As the elders put it: “Our people and our way of life are being exposed to danger and we do not understand why.”
Paulette Jordan is running for governor of Idaho. This is a big deal in so many ways. First, there have been very few Native Americans who have ever run at that level (Alaska’s Byron Mallott, Idaho’s Larry EchoHawk, and Peggy Flanagan in Minnesota). Second, she’s the first Native woman who has the audacity to ask citizens to run their state. Yay! And third: She already knows how to win over conservative voters.
Two years ago when Democrats were losing across the country, Jordan captured her second term as a state representative, winning by 290 votes. This doesn’t sound like a lot, but she won her race during a Republican wave. She was the only Democrat to win any office in North Idaho.
Jordan announced her candidacy Thursday night in Moscow, Idaho. She is a native of Idaho and a citizen of the Coeur d’Alene Tribe of Idaho. (She served on the tribal council from 2009 to 2012.
“I grew up in a farming family and my grandparents showed me that cultivating the land was a continuation of our ancestral traditions of caring for homelands,” Jordan said. “Coeur d’Alene peoples have cared for Idaho homelands since time immemorial and Idahoans today practice the same combination of self-sufficiency and cooperation that my grandparents did. This reminds me of how connected we are to one another, it reminds me that Idaho is my family.”
Rep. Jordan is currently serving her second term in the Idaho House of Representatives. She is a member of the Idaho House Resources and Conservation Committee, State Affairs Committee, and the Energy, Environment & Technology Committee.She is also an appointed Idaho Representative to the Energy and Environment Committee of the Council of State Governments for the Western Region.
At her announcement, Jordan said, “when asked, what are you going to do next to improve this world? I am going to run for governor.”
Idaho once regularly elected Democrats to state office, including former Interior Secretary Cecil Andrus (who won office a record four times). These days it’s a super-majority Republican state. But it doesn’t have to be that way. Idaho is also state where the legendary National Congress of American Indians President Joe Garry served in the state senate and was a candidate for the U.S. Senate. It’s where Jeannie Givens served in the legislature and ran for the U.S. House of Representatives (likely the first Native woman to do so). Both Garry and Givens are also Couer d’Alene tribal members. It’s also a state that that sent Larry EchoHawk, a Pawnee, first to the legislature, and later elected Idaho’s state’s Attorney General. He did lose a bid for governor. But the point is that Jordon has an uphill climb. And she could win.
One telling story about Jordan is that she lost her first race for the legislature in 2012 by less than a hundred-fifty votes. She went back to work — and won two years later. And again four years later.
Jordan said there is even an advantage to being a member of the minority party. “The majority party can be insular and keeps their circle small, because they do not need to cooperate to advance their goals,” she said in her announcement news release. “But, members of the minority party must engage colleagues across the aisle, and develop meaningful comprehension of policies and positions held by others, so that the shared work of governing can succeed.” Jordan continued, “In my family, our circle can always get bigger, and that’s what I see for Idaho. A bigger circle is what achieving justice for all looks like.”
Congress has yet to reenact the Children’s Health Insurance Program and states will soon run out of funds to prop up the program. That will mean that thousands of American Indian and Alaska Native children will lose their health insurance. And, the result is the Indian Health Service will have to stretch its already thin dollars to try and cover the budget hole.
The Children’s Health Insurance Program expired Sept. 30. This federal program insures young people and pregnant women who make just enough money not to qualify for Medicaid (but can’t afford private insurance). The idea is to make sure that every child has the resources to see a doctor when they are ill.
It’s hard to break down precise numbers because agencies lump funds from the Children’s Health Insurance Program or CHIP into Medicaid data. But we do know that the law worked really well. We also know there are more than 216,000 children that have health insurance because of Medicaid and the CHIP. Indeed, Native American children rely on Medicaid and CHIP at much higher percentages than other population groups. A study by Georgetown reported that 54 percent of American Indian and Alaska Native children were enrolled in Medicaid or CHIP as compared to 39 percent of all children. “Even though much progress has been made in extending Medicaid coverage to American Indians and Alaska Natives, the uninsured rate for American Indian and Alaska Native children and families remain unacceptably high,” the report said.
Overall the uninsured rate among non-elderly American Indians and Alaska Natives fell by 7 percentage points from 24 percent to 17 percent, according to the Kaiser Family Foundation.
This is a big deal and here’s why: The Indian Health Service is a health care delivery operation that works best when insurance (third-party billing in government-speak) pays for the medical costs. Medicaid, CHIP, Medicare, and other third-party billing now accounts for 22 percent of the IHS’ $6.15 billion budget.
But if Children’s health is no longer funded (because Congress did not reauthorize the legislation) then the Indian Health Service will have to make up the difference. That means taking money away from other patients and programs. It will be a critical problem for clinics because by law dollars from third-party billing (or Medicaid and CHIP) remain local.
Alaska is the state most impacted by Congress’ failure to act because two-thirds of the children in the Native health system are covered by Medicaid or CHIP. Other states where there will be significant hits: Montana, North Dakota, South Dakota, Washington, New Mexico, Oklahoma, North Carolina, and California.
The House of Representatives passed a CHIP reauthorization in early November. But that bill included a $6.35 billion budget cut to other health programs, including the Prevention and Public Health Fund, which provides money for vaccines, smoking cessation, and other initiatives to improve public health. The House would also ban lottery winners from being insured by Medicaid, tighten the timetable for people to sign up, and to change other rules.
It’s unlikely the Senate will agree. But the Senate is not moving quickly to pass its own legislation. The Senate is too busy working out tax cuts that will benefit large corporations and the very wealthy. (Previous post: What matters? Tax fight is about seven competing values.)
Across the country, some nine million low- and middle-income children rely on CHIP for health coverage. And, according to The Hill newspaper, States have asked the Centers for Medicare and Medicaid Services for funding to hold them over in the interim, and the agency has awarded about $607 million in redistributed funds to states and U.S. territories. Tribes will also lose hundreds of thousands of dollars in CHIP-related grants.
Last month, Utah Republican Orrin Hatch, who chairs the Senate committee responsible, called CHIP a “top priority” that had bipartisan support. The committee passed the bill October 2. But it’s up to Majority Leader Mitch McConnell, R-Kentucky, to bring the legislation to the floor for enactment. Then the House and Senate would have to iron out and agree on their differences before the bill can become law.
Why Indian Country should have a voice in this debate
Mark Trahant / Trahant Reports
There is no better way for any legislature — be it a tribal council, a state assembly, or a Congress — to telegraph what’s most important to a society than through tax policy. How a government collects revenue says what constituent groups are seen to matter. And, conversely, what groups and issues are insignificant. And, that of course, is Indian Country.
As Adrian Sinclair wrote in Cronkite News: “Indian Country once again does not have a seat at the table.” Tribes “aren’t treated the same as state and local governments across the board on a whole series of issues,” John Dossett, general counsel for the National Congress of American Indians, said after the hearing. “Tribes are … either ignored or they’re an afterthought.” He said there are many cases where state governments have more power than tribal governments, like the federal Adoption Tax Credit, which gives a credit to parents who adopt a child with special needs. But the credit only applies when a state court, not a tribal court, rules that a child has special needs.
So Indian Country is a perfect illustration for my larger point: A country’s tax policy shows what it values. The key to this idea is simple when a nation wants more of something, then taxes it less. And, other hand, if a nation wants less of something? Tax it more.
All interest on debt was deductible when the first income tax was created in 1894. Why? Because Americans did not like to borrow. It was almost immoral. As a writer for Harper’s Weekly warned a man in debt “must smile on those he hates, he must extend his hand where he would strike, he must speak pleasantly with a curse in his throat … He wears dependence like a yoke.”
But Congress made debt a better deal. You could borrow money for that new farm, or especially a home, and the government would subsidize the loan by making it a tax deductible transaction. By the 1920s car loans were the bigger deal. Americans were borrowing, buying and deducting. Congress created a monster with that policy and today debt is one of America’s great loves. Then in 1986 Congress switched gears: Today individuals can only deduct mortgage interest. But even that single benefit was generous. You could buy a big house. A bigger house. A ginormous house. And deduct 100 percent of the interest up to the cost up to $1.1 million of debt. And that tax deal includes second homes.
So as a policy the Congress was telling we the people buy bigger houses. And go ahead, get that second house in the woods or on the lake.
That’s what tax reform is, setting parameters for what the elected leaders think important for a national policy. So, if it becomes law, this tax reform will change the way we consumers spend money. Perhaps we’ll buy and build smaller houses and rent a cabin on the lake instead of purchasing one. This might be a good outcome for all of us. This is actually a pro-climate policy (please don’t tell Congress.)
This same priority process is true for renewable energy. Congress created incentives for wind, solar and other renewable energy. But, now the Republican plan is to reverse course, and reward oil, gas, and especially coal. Tax policy will favor fossil fuel development and renewable energy will therefore cost more. But will companies still invest? Who knows? We do know the calculations will be way more complicated. And, did I mention, renewable energy will cost more.
Let’s consider the overarching messages, the narrative, that will form policy in the tax bill before the Senate and the one already passed by the House of Representatives.
ONE: The bigger the corporation, the bigger the break
The tax bills paid by corporations are driving the legislation in both the House and the Senate. Republicans argue that if taxes are lower, companies will invest more in the United States (instead of other countries) and hire more people at higher wages. This debate is complicated because the current tax code is full of loopholes (something that Republicans say will be fixed). But the bottom line is that U.S. companies have a higher tax rate than what other countries charge, but, and this is huge, the companies actually pay less in federal taxes than what other other countries charge.
As the Harvard Business Review says: “First and foremost, corporate taxes are important because they help pay for government services. While they don’t account for as much U.S. tax revenue as they once did, they remain one of the central ways the government raises funds. According to the Tax Policy Center, “The corporate income tax is the third largest source of federal revenue, after the individual income tax and payroll taxes.”
The House bill cuts the top rate that large corporations pay from 35 percent to 20 percent. It would be the largest one-time drop in the big-business tax rate ever. And it’s a permanent change (the individual rates expire after a decade) at least until there’s another tax bill.
Companies will also get more deductions for purchasing new equipment. And there is an incentive for companies to move their profits back to the United States from low-tax countries.
The Senate bill is evolving. It also rewards big business. But in order to reduce the cost of the entire package, it delays reducing the corporate rate until 2019. (Imagine every business in the country holding off on just about any new activity because the tax laws changed next year.)
The metaphor: Multinational corporations rule.
TWO: It’s tough being rich
The New York Times’ Nicholas Kristof writes that it’s hard being a billionaire these days. “Why, some wealthy folks don’t even have a home in the Caribbean and on vacation are stuck brooding in hotel suites: They’re practically homeless! Fortunately President Trump and the Republicans are coming along with some desperately needed tax relief for billionaires.”
One way this works is be reducing the tax when someone inherits a wealthy estate. Both versions start this tax at $11 million. The House eliminates the so-called “death tax” in 2024 while the Senate keeps the tax but raises the exemption.
A second provision changes what’s called the Alternative Minimum Tax. The way that works is that after a tax return is completed, and there’s a whole slew of deductions, there is a calculation to see if that taxpayer should still pay something. The idea is to make sure that people earning more than $130,000 a year still pay an income tax, even if they find deductions in every corner. That goes away.
And there is one more goody for the rich. Charitable contributions can still be deducted.
The metaphor: Wealthy families so need our help. OMG.
THREE: Why work?
This part of the debate starts with the corporate tax rates. The Trump administration argues that cutting corporate taxes will benefit workers because companies will reward workers with better wages.
Treasury Secretary Steven Mnuchin claims that “many, many economic studies show that more than 70 percent of the burden of corporate taxes are passed on to the workers.” However economists are divided. As the Center for Budget and Policy Priorities points out “this claim is misleading … the evidence indicates that most of the benefits from a corporate rate cut would go to those at the top, with only a small share flowing to low- and moderate-income families. Mainstream estimates conclude that more than one-third of the benefit of corporate rate cuts flows to the top 1 percent of Americans, and 70 percent flows to the top fifth. Corporate rate cuts could even hurt most Americans since they must eventually be paid for with other tax increases or spending cuts.”
The bottom line is that the tax bill will not make life easier for people earning under $75,000 a year. The income tax portion might go down (depending on family size, smaller in this case is better) but costs will go up for education and health care.
And, on top of that, this tax policy will sharply reduce federal spending across the board. Last week the National Congress of American Indians (NCAI) and the Native American Finance Officers Association (NAFOA) came out against both the House bill and the Senate Finance Committee bills in part because of this point. “NCAI and NAFOA view it as deeply regrettable that neither the House nor the Senate bill takes seriously Indian Country’s priorities for tax reform,” a news release said. “With respect to tribal nations, unless tribal provisions are included, the current tax reform legislation amounts to little more than a $1.5 trillion increase in the federal deficit over the next ten years. This deficit increase will inevitably create pressure to cut federal programs and services that are extremely important to tribal communities. Deficit-financed tax cuts that lead to austerity budget cuts would affect all Americans, but would disproportionately impact American Indians and Alaska Natives who rely on federal funding of the trust responsibility as well as social programs.”
The metaphor: Workers don’t matter.
FOUR: Help mom and pop sell stuff
Most people who own a small business structure their entity as Limited Liability Corporations, S-Corps, or a partnership. This means that the income generated is reflected on the individual’s tax return. The House lowers the taxes on profits from 39.6 percent to 25 percent and has a 9 percent increase on the first $75,000. The Senate goes a different route with a new incentives for small business. This is “pass through income” because of the structure. And this part of reform really does solve a problem. Small business is critical — especially in Indian Country — but does not get the attention (or the breaks) that large corporations do.
Rep. Markwayne Mullin, R-Oklahoma, said last week, “As a former small business owner, I understand firsthand how burdensome the current tax code is on Main Street. The Tax Cuts and Jobs Act delivers relief to mom-and-pop shops in our communities so that they can hire more individuals, grow their business, and invest more in our local economy.”
The metaphor: Small business is cool, too.
FIVE: Elite colleges? Or is it, college only for the elite?
The House bill is an all-out attack on higher education. This is nonsense. Especially when the country needs to be competitive in a digital, knowledge-based world.
First up: Tax private universities’ endowments with a tax of 1.4 percent on portfolios that exceed $250,000 per full-time student. Only about a hundred schools would be affected, and it penalize colleges that have resources. Since those university operating costs will not go down, it’s not likely that this will result in more financial aid for students. The House also makes it impossible for tax-exempt bonds from private — and some public — institutions. This will make campus construction projects more expensive.
The House bill eliminates the deduction of interest for student loans. Americans now owe more than $1.4 trillion on student loans. It already is making it more difficult for young college graduates to buy homes, and transition into the middle class. This provision will be just one more thing. (And student loans are already stacked against the borrower. You can’t get rid of them in bankruptcy.) So instead of solving a problem, Congress is making it worse.
The House bill also repeals the Lifetime Learning Credit, eliminates the Coverdell savings accounts, but does expand the American Opportunity Credit.
The House bill would also classify tuition waivers as income (making a graduate student wealthy for tax purposes.) Imagine a “bump” in student’s income that is equal to tuition, some $30,000, $40,000 or even more.
Laurie Arnold, Colville, director of Native American Studies and an Assistant Professor of History at Gonzaga University, remembers trying to explain this to Congress when she was in graduate school. “Many members of Congress had children enrolled in large/research universities, yet had no idea that graduate students teach the majority of introductory classes at those institutions. In general, the disconnect about this was broad, and many Members fell back on the language that not taxing the stipends was simply another tax break.”
Stipends are now taxed. And Congress is keen to add tuition waivers to the tax revenue pool. This will make it more difficult for people to pay for graduate school, and increase the debt levels for those who do. As a national policy this makes no sense. None.
As UCLA neuroscientist Astra Bryant told Wired magazine: “I mentor two underprivileged undergraduate women, and my concern for them is that an increased tax burden would make it financially impossible for them to afford to pursue a PhD.”
And for Indian Country? There is already a shortage of graduate students and PhDs. Why should it be made more difficult?
“Let me distill that: over one third of American households had trouble putting food on the table, putting a roof over their heads, or getting medical care; blacks and Hispanics are falling further behind whites in net wealth; and 99 percent of Americans hold a diminishing 76 percent share of income in the U.S. These are all alarming trends, but to have one-in-three consumers report that they cannot regularly put food on the table in the U.S., one of the wealthiest countries in the world, is the most deeply disturbing,” Busette writes. “Such a miserly budget, in combination with the tax reform plan, could mean the loss of some very important services for low-income and poor Americans.”
The tax reform measures will require massive budget cuts. Soon. Tribal governments will be hit hard. We already know how difficult sequestration was for tribes a few years ago. The kinds of cuts that will be needed to pay for these tax cuts will cost significantly more than sequestration.
The Center for Budget and Policy Priorities pegs these coming budget cuts at $5.8 trillion, $800 billion in cuts below sequestration levels.
The metaphor: You can’t afford to be poor.
SEVEN: Obamacare? Really? Again?
A serious question: Which house of Congress hates healthcare more?
The House kept the Affordable Care Act insurance mandates, but eliminates medical deductions. So a family that is dealing with a catastrophic, expensive medical event won’t be able to offset any of those costs from their tax bill. Already this provision is limited to higher income taxpayers. It’s only open to people who itemize their deductions, an estimated 8.8 million claimed it on their 2015 taxes, according to the IRS. But for those families that need this break, it’s a big deal.
Then the best thing Congress could do to help people with medical debt is to legislate another expansion of Medicaid. As Kaiser Health News reported: “A study from the Urban Institute may shed light on why Medicaid eligibility remains a pressing problem: medical debt. While personal debts related to health care are on the decline overall, they remain far higher in states that didn’t expand Medicaid. In some cases, struggles with medical debt can be all-consuming.”
The Senate is using tax reform to repeal parts of the Affordable Care Act. Again. The Senate would “save” money by ending the requirement to purchase insurance. It saves tax dollars because the government would not have to pay the subsidies for those who sign up under the plan (including those from Indian Country who get no cost plans under the exchanges).
And, repeating myself here, should a form of these bills become law there will be cuts across the board. The Indian Health Service (as well as Medicaid) will need to restructure because it will have so many fewer dollars.
The metaphor: Healthcare is only for those who can afford it.
A cold December
Congress wants to wrap up this debate before the end of the year and begin the provisions in the new tax year.
One more thing about values. The two tax bills define what’s important to a society. Alaska’s Sen. Lisa Murkowski was a champion on health care and was a key vote to stop the last Affordable Care Act repeal effort in the Senate. But this time there are competing values. She has also been a longtime supporter of opening the Arctic National Wildlife Refuge to oil and gas development. That’s in the bill. It’s her provision. So is she willing to give up on health care for more oil? And what about climate change? Murkowski was eloquent at the Alaska Federation of Natives saying that she is witnessing first-hand the impact in northern communities. This tax bill gives fossil fuels a boost — at the expense of the climate.
What’s really important? We are about to find out.
First: Gerrymandering can be defeated. The election districts in Virginia were designed to support incumbents, and especially Republicans. The Atlantic described the “well-documented” Republican operation to gain “control of the mapmaking process in 2010 (and) saw their share of legislative seats steadily grow, even as their actual vote shares decreased. In other words, these maps helped Republicans retain majorities even when they earned substantially fewer votes.”
That changed Tuesday. Voters swamped the supposedly safe districts and Democrats gained significantly. Perhaps even control of the legislature (votes are still be counted and will be recounted in a key race). So turnout beats districts drawn by one side to win. (The definition of gerrymandering.)
Second: Minority parties can win in this election cycle. It’s always tough to run as a third or fourth party candidate in the United States. The deck is stacked. The system is rigged to favor the two established parties. However some twenty-plus self-described Democratic Socialists (ala Bernie Sanders) won on Tuesday, including Denise Joy in Billings, Montana. Joy was elected to the city council.
This could be an interesting trend.
Some states, California and Washington, have top-two primaries. That means a candidate can win even without party affiliation. But in most states — unless the rules change — the biggest opportunity for socialists, independents and Green Party candidates is for offices such as school boards and city councils. Another mechanism that makes it easier for third party candidates is ranked choice voting (where you pick your favorite, second favorite, etc.) Several cities, such as St. Paul, Minnesota, now use that approach. Maine also voted to adopt ranked choice, but has not yet implemented it because of opposition from the legislature (and entrenched parties).
In Arizona, Eve Reyes-Aguirre (Calpolli) is running for the U.S. Senate on the Green Party ticket. She is a co-chair of the Global Indigenous Women’s Caucus and a co–founding Mother of the newly formed World Indigenous Women’s Alliance. She was also a representative at the United Nations Commission on the Status of Women for the American Indian Law Alliance- 2015, 2017. Reyes-Aguirre is also running against the two-party system. Her web site says: “The two-party system has allowed wealth inequality to skyrocket to it’s highest point since the 1920’s. Eve is committed to developing an economy that promotes a equal sustainable quality of life for more families through the enactment of a living wage, limitations on corporate tax incentives, and a truly progressive tax structure. We must all be treated equal to live equal.”
That brings to eight the number of Indigenous candidates running for the U.S. House or Senate so far in 2018 election. Three Republicans — Rep. Tom Cole (Choctaw), Oklahoma; Rep. Markwayne Mullin (Cherokee), Oklahoma, former state Sen. Dino Rossi (Tlingit), Washington — and four Democrats — former state NM state Democratic Party chair Deb Haaland (Laguna), Carol Surveyor (Navajo) in Utah, Tahlequah Mayor Jason Nichols (Cherokee), and J.D. Colbert (Choctaw) in Texas.
Lesson three. This is the “when” to jump and run in 2018 races. So much about politics is timing. Good candidates sometimes, no often, lose because their timing is off. It’s not the right cycle. There are too many headwinds. Barack Obama generated turnout that encouraged Native voters and candidates. The chaos of 2016 with Hillary Clinton and Donald J. Trump did just the opposite. Turnout was down, especially in Indian Country. But we know most Native American candidates are already outsiders. So we need a little luck. And good timing.
The 2018 election ought to be that. President Trump and his Republican Party have to defend infighting plus legislative failures from healthcare to possibly taxes. And the president’s popularity is only about a 38 percent approval rate. Awful numbers. On top of that, even popular presidents lose midterm elections. Democrats lead in the average of generic polls, 47 percent to 38 percent.
But Indian Country needs more candidates, especially in districts that can be won in this climate.
My top pick: Alaska’s at large district. Several Alaska Natives have challenged Rep. Don Young for this seat over the years, including Willie Hensley (Iñupiaq), Georgianna Lincoln (Athabascan), and Diane Benson (Tlingit). And Young seems invincible. He was first elected in 1973 and is the longest serving member of the House. But, if this is a wave election, then no member of the House is invincible. And, even better, there are some really strong potential Alaska Native candidates.
At one point during the 2016 election cycle (which we now know was not good timing) there were more than a hundred Native American candidates. We need those kind of numbers again. Especially this time around. There are more than 62 Native Americans serving in state legislatures around the country and many of those will be running for re-election.
So that brings me back to rule 3, part A. It’s my favorite rule in politics because it’s so simple: You gotta run to win.
A year ago ballots from across the country were being examined by citizens, journalists, and politicians, who were all wondering, “What the hell just happened?” The nation woke up to a President-elect Donald J. Trump.
And this morning? The Trump brand is like an overpriced hotel where you would never, ever stay a second time.
Voters from Maine to Washington and all points in between rejected Trumpism. They voted for Democrats, flipping legislatures in Washington and possibly Virginia. They voted for Medicaid. Medicaid! They voted for higher wages. And there is a clear message to Congress (if members pay attention) that governing still matters.
It was a good night for Native American candidates, too.
In Washington, Roxanne Murphy, Nooksack, won a second term on the Bellingham City Council with nearly 80 percent of the vote. What’s striking is that she ran against the ugly words of an opponent who called on hate instead of discourse. Murphy wrote on Facebook: “Got through so much racism and misogyny during this run for office. But that was all worth it for me to defend our Bellingham community, the work of our current Bellingham City Council, to mutilate a deplorable person at the polls, get more people to vote the whole ballot, and it proved that love can win over hate. Thank you for RoxingTheVote!”
Several other Native candidates won office in Washington. Chris Roberts , City of Shoreline, Zachary DeWolf, Seattle School District, and Candice Wilson, to the Ferndale School Board.
Washington voters also flipped the legislature from red to blue. The entire West Coast is now governed by Democrats.
Renee Van Nett, Leech Lake Ojibwe, won a seat on the Duluth, Minnesota, city council. She will be the first Native American woman on that body. She told the Duluth News Tribune that her victory was a credit to “traditional issues that people are worried about … they want someone who’s accessible, someone they can call and talk to, someone who will address their needs. They want economic development. They want to be heard.”
Across the country “diversity” was a theme from election night. The “first” is a phrase that seems odd in 21st century America. Yet the first African American Lt. Governor in New Jersey. Another in Virginia. (Hint: The first Native American woman to serve in that capacity should be be next up, Peggy Flanagan in Minnesota.)
The first Sikh mayor in Hoboken (who had to run against overt hate). The first immigrant from Liberia in Montana. The first openly lesbian mayor in Seattle. (Huffington Post has a list of many of the firsts.) The main take away: This was a rejection of the narrow world view of the Trump. The diversity that is the future of America, won. Bigly.
On the policy debate ahead, perhaps the most important vote came from Maine where voters overwhelmingly voted in favor of expanding Medicaid. Maine is one of 19 states whose Republican governors or legislatures have refused to expand Medicaid under Obamacare. This is an initiative — and a process — that could move to other states. “This will send a clear signal to where the rest of the country is on health care,” Jonathan Schleifer, executive director of the Fairness Project, told The Washington Post. This vote is important because it could tip the scales in states where the legislature says one thing and the people another. Alaska. Cough. Alaska. Put Medicaid expansion on the ballot: And it will win.
Elections, of course, are always snap shots. It’s dangerous to think this rout means more of the same a year from now. But the groundwork is there. And this election night will further divide many Republicans from Trump — as well as those who fund elections. There is now real evidence from the best poll of all that voters are not happy with the direction of Congress or the White House.
Two serious debates in Washington right now: Climate change and taxes. These are connected. And the decisions made over the next few days and weeks will impact you and your children’s future.
The federal government is required by law to publish a climate assessment. The report is out and it’s troubling. “Climate change, once considered an issue for a distant future, has moved firmly into the present. Corn producers in Iowa, oyster growers in Washington State, and maple syrup producers in Vermont are all observing climate-related changes that are outside of recent experience. So, too, are coastal planners in Florida, water managers in the arid Southwest, city dwellers from Phoenix to New York, and Native Peoples on tribal lands from Louisiana to Alaska.”
The National Climate Assessment concludes that the evidence of human-induced climate change continues to strengthen and that impacts are increasing across the country. This bill was required by Congress in 1990 to “understand, assess, predict and respond” to global warming. It represents the best science from across the federal government.
So how is the Congress and the Trump administration responding to the report?
Well, the White House basically said, no worries, the climate is always changing. Especially because the president and Congress are focused instead on tax cuts.
Tax policy is, of course, an important concern for tribal governments and enterprises. As Adrienne St. Clair reported for Cronkite News about a complaint from tribal leaders about not being included in the discussion. “Tribes struggle with economic growth because of things like basic federal tax law, dual taxation from state governments and budget cuts from the federal programs that serve them. They urged lawmakers to push for legislation that will help Indian Country, including increasing investment incentives and allowable tax credits,” St. Clair wrote.
And it’s not just tribes. A restructuring of federal taxes will impact American Indians and Alaska Natives in all sorts of ways.
I get tired of the debate being about “middle class” taxpayers. First of all, I (and most policy makers) don’t really know what that means any more. Most working families consider themselves middle class. And what about a young single mother trying to raise a family on $25,000 a year? In an ideal setting she would not pay any income taxes.
And the Republican proposal (that party distinction is important because there were no open hearings, or amendments, this is a Republican bill designed to win or lose on Republican votes) on the surface will save many American Indian and Alaska Native families money. The tax proposal would double the standard deduction to $12,000 for individuals and $24,000 for joint filers. That’s the amount of money you can earn sort of tax free. But the plan takes away deductions for children — so a larger family could end up paying more from the start because of the fewer deductions. (So less than half needed for the scenario of a single mother raising children.)
And that’s not all. The tax cuts for families don’t last. The Joint Committee on Taxation (the congressional agency that does the math) reports that families earning between $20,000 and $40,000 a year and between $200,000 to $500,000 would pay more in individual income taxes in 2023 and beyond. Republicans argue the tax measure would result in a million new jobs.
The total cost is not a bargain either, the tax cuts would add some $1.5 trillion to the debt over the next decade.
There is another problem for Indian Country. This tax proposal is linked to a budget measure that has already passed Congress. And that budget calls for deep spending cuts across federal programs — think sequester times two or three. And because of the process used: the Senate will need just 50 votes to implement these severe budget cuts.
Congress’ budget also opens up the Arctic National Wildlife Refuge to oil and gas development — and an increase in fossil fuel production (the very cause of climate change).
This is a tough moment for that. The National Climate Assessment says Alaska is already at risk. “Alaska has warmed twice as fast as the rest of the nation, bringing widespread impacts. Sea ice is rapidly receding and glaciers are shrinking. Thawing permafrost is leading to more wildfire, and affecting infrastructure and wildlife habitat. Rising ocean temperatures and acidification will alter valuable marine fisheries.”
The Trump administration and the Republican leaders in Congress have made tax cuts their most important initiative. But the divide is similar to what we saw in the bills to repeal the Affordable Care Act. So the outcome is uncertain at best. And, unlike health care, there might be enough votes in either the House of Representative or the Senate to tank the tax bill.
However on Fox News Sunday Speaker Paul Ryan said the House is “on track” to pass this legislation before Thanksgiving. Hashtag: #TurkeyAlert.
New Mexico congressional candidate Debra Haaland is criss-crossing Indian Country determined to get her name out there — and to raise enough money to be competitive. She began in Milwaukee at the National Congress of American Indians annual convention and she ends the week in Anchorage at the Alaska Federation of Natives convention.
Politics is a tough business. Most Native American candidates cannot dip into their personal wealth to run for office (at least the Democrats). It’s raising money five bucks at a time. A good haul is when someone writes a check with more than one zero. Yet it’s hard to understate how important that money hunt is to a campaign. Haaland, unlike most Native American Democrats, is running in a district with a lot of other Democrats. That means she has an excellent shot at capturing a seat in Congress — the first Native American woman to do that — but first she must win a crowded primary. Haaland is Laguna Pueblo.
A Thursday night fundraiser in Anchorage was typical. It was much more of an introduction than a call for hard cash. That’s important. It was great to hear stories. We need that in politics. But it will take money, too. If we really want to see more Native Americans in Congress, thousands of five-plus dollar donations will make all the difference.
At that event one of the most touching moments was when Diane Benson, who ran for Congress in Alaska against Rep. Don Young, talked about why she ran. Her son had been injured in the military and yet politicians were making war and peace decisions without an understanding of the consequences. Benson is Tlingit.
I have been collecting information about Congress and Native American representation. And, it turns out, I was wrong about the actual numbers. I checked this morning and according to the House of Representatives historian since March 4, 1789, there have been 10,273 people elected to that body. (I was using a smaller number.) There has never been a Native American woman. Ever.
This is my “I am wrong post” because I also was missing an important name, Georgianna Lincoln, from my list of Native women who have run for Congress. Lincoln, a former state Senator, is Athabaskan, and she also ran against Rep. Young in Alaska.
So here is my list, starting in 1988, Jeanne Givens, a Couer d’Alene tribal member in Idaho was the first. Then Lincoln in Alaska, Ada Deer, Menominee, in Wisconsin, Kalyn Free, Choctaw, in Oklahoma, Diane Benson, Tlingit, in Alaska, and Denise Juneau, Mandan Hidatsa Arikara, in Montana. Three Native women have run in the Democratic primary in Arizona: Mary Kim Titla, White Mountain Apache, Arizona Rep. Wenona Benally, Navajo, and Victoria Steele, Seneca. And in this election cycle, Carol Surveyor, Navajo, in Utah and Haaland.
I better stick with “at least” because I am sure more names will surface. But the point remains: It’s long past time to elect the first Native American woman to Congress. After 10,273 (add another 435 for next November) elections we need a first. And a second. And more, real representation.
Let’s do the numbers. We have the first round of campaign finance reports out and there are seven Native American candidates for Congress, three Republicans and four Democrats.
And in the money chase, it’s the Republican candidates raising the dough. Former Washington state Sen. Dino Rossi, running in Washington’s 8th, in this quarter reports $578,822. To put that amount in perspective: That’s more than the incumbent, Rep. Markwayne Mullin, and nearly as much as Rep. Tom Cole. Mullin raised $511,017 this quarter. And Cole is at $640,649 (with $1.7 million cash on hand).
Rossi is Tlingit, Mullin is a member of the Cherokee Nation, and Cole is Chickasaw.
On the Democrats’ side the numbers are smaller.
Haaland has raised $262,098 so far in this election cycle. She’s second in the money race in her Albuquerque district. Remember this election is as much about the June primary as it is the general election because it’s a Democratic-leaning district.
Tahlequah Mayor Jason Nichols, Cherokee, is running against Rep. Mullin. He has yet to file any campaign reports. No reports are listed for Carol Surveyor in Utah and J.D. Colbert in Texas.