Alaska’s Walker, Mallott seek second term; plus NM, Utah and Oklahoma races

*** Updated to include new candidate, maps.

image.jpeg
Time flies. Alaska Gov. Bill Walker, Lt. Gov. Byron Mallott are seeking a second term for their independent partnership. (Photo via Facebook.)

Mark Trahant / Trahant Reports

I have been avoiding politics. Last year I was consumed by dozens of races across the country, building data bases, checking names, and generally being enthusiastic. Now? Well, this year, I have been absorbed by the Republican plans to rewrite the Affordable Care Act, destroy Medicaid as we know it, and, as a by-catch, sabotage the Indian Health system.

Of course policy and politics are connected. The people we elect are the ones who make the decisions about our health care, our education, how much money the government spends and collects, or whether we’re at war or at peace. Imagine being a Native American politician in the Trump era. It would be an uphill climb to represent constituents as well as being a public advocate for Native people and community.

Labor Day is always the big weekend in politics. In an election year, it’s the date when campaigns really gear up, there is a crunch of about nine weeks until votes are counted. For the 2018 cycle, that marker is still more than a year away. Yet late summer is when candidates are recruited, a few take the plunge, and those who say yes, build campaign organizations and raise money.

There is a lot to report about American Indian and Alaska Native candidates.

Starting in Alaska where Gov. Bill Walker and Lt. Gov. Byron Mallott are running for re-election. In 2014 Walker and Mallott ran a campaign that transcended party politics. Mallott, a Tlingit and former chief executive of Sealaska Corporation, had been the Democratic Party’s nominee for governor until he dropped out to join Walker. This was politics at its best. I remember being at several campaign events, including a couple panels I moderated, and was struck by the similarity of their messages (and more important, their tone) so coming together was good for the polis, a Greek word that means the ideal in a community.

Mallott told Juneau radio station KINY that the pair would again run as an independent team. “What ever we do, we’ll do together,” Mallott said. He said party labels do not come up in their governing plans because they’re more interested in solving problems. Walker and Mallott took office with the state facing an unprecedented fiscal crisis brought on by low oil prices and structural deficits. Mallott called it a slow rolling recession. “We need to put this behind us,” he said, “so Alaska can grow again.”

Walker and Mallott officially filed for re-election on August 21 as independent candidates.

This will be a tough race. Walker and Mallott have raised issues that are not exactly popular, such as reducing the state’s permanent dividend (per capita to you and me) as well as implementing new taxes to pay for government.

There are not that many independents in state governments (or the federal government, for that matter).  So it will be interesting to see if Democrats again choose to align with Walker and Mallott. (Alaska’s House is also run by a partnership of Republicans and Democrats working together, while the Senate remains under Republican leadership.)

For their part, Republicans are operating as if the Democrats will field a candidate (one name tossed about is former Sen. Mark Begich). The state’s party chair, Tuckerman Babcock told KTOO television that “from our perspective, having two Democrats running is a good thing.”

Walker and Mallott have a track record. If nothing else (and there is a lot more) they can be proud of expanding health care access in Alaska through Medicaid expansion. This program opened up health insurance to at least 35,000 additional Alaskans and improved the funding stream for the Alaska Native health system. The uninsured rate in the state dropped from 18.9 percent to 11.7 percent. A success story all around.

One measure of that success: A group of doctors is promoting a ballot initiative to codify the Medicaid program in Alaska (protecting the program no matter who is governor).

 

20768231_2035863566642364_2293119250089236078_n.jpg
Kelly Zunie (Facebook photo)

Kelly Zunie is running for the Republican nomination for New Mexico’s lieutenant governor. She is a member of the Zuni Pueblo and served as Cabinet secretary for the New Mexico Indian Affairs Department for nearly three years.

Her campaign Facebook page said:  “Zunie is committed to meeting the needs of New Mexico’s private sector business owners to improve capacity to expand and the workforce. Zunie will also focus on the safety of New Mexico’s children and families.”

18300873_1364236553670398_341276613136428894_n.jpg
Former New Mexico Democratic Party Chair and candidate for Congress Debra Haaland. (Campaign photo)

 

On the Democratic side, Debra Haaland is running for New Mexico’s first congressional district. (Previous: Pueblo woman. Mom. Gourmet cook … candidate for Congress.) Haaland previously has been a Democratic nominee for Lt. Gov. and served as the state’s party chair. Now she’s running in a contested primary for the state’s most urban district (and only a little more than 3.5 percent Native American). She’s a member of the Laguna Pueblo.

The key to winning this race is building up enough financial resources and early ballot strength to win the primary. Haaland has already raised more than $150,000, including significant sums from Indian Country contributors. Joe Monahan’s New Mexico political blog put it this way: “Something a bit historic is happening in the early going in the Dem race for Congress. Large sums of money from Native America tribes and pueblos here and outside the state is starting to flow to Haaland, who would be the first Native American woman ever elected to the US House.”

carolsurveyor.jpg
Carol Surveyor, candidate for Congress in Utah.  (Facebook photo)

And in Utah, Carol Surveyor is running for the House in that state’s second congressional district. Surveyor is Navajo and a political organizer, co-founder of Utah League of Native American Voters. Surveyor told Enviro News Utah that it’s about time a Native American woman served in Congress. “Women of color are often overlooked in their opinions, their views, their leadership, and so forth,” she said. “Native Americans have traditionally been overlooked and forgotten in this country, women in native communities are traditionally matriarchal. Yet, there have been many native women who have run for public office. In the past, there are native women who have run for federal office, but unsuccessfully. Again, I think this is because politics is still viewed as a men’s game. My remark about “it is time,” refers to changing the game, and what better way to change the entire game than by electing a Native woman? Doing so would be a shift in the way many people the world over see the U.S., how many people see U.S. politics in this country, and it would show how progressives in the U.S. recognize and understand the forgotten voices. I am a forgotten voice.”

The web site, Indianz.com, posted a story that said J.D. Colbert, a citizen of the Chickasaw Nation, is running for the 3rd Congressional District in Texas. “Voters there haven’t elected a Democrat there in 50 years but the banker and business leader is counting on a shift in demographics to send him to Washington, D.C. ‘America is in the crucible of seismic demographic transition. The impending death of the White majority and the rise of a more diverse New America is the fundamental cause of divided America and is the basis of the divisive cultural wars,’ said Colbert, who is also a descendant of the Muscogee (Creek) Nation.”

IMG_6758-1.jpg
Tahlequah Mayor Jason Nichols (photo: Oklahoma Municipal League)

Finally, there is an interesting twist in Oklahoma. Remember there are currently only two tribal members in the Congress, both Republicans. U.S. Representatives Tom Cole and Markwayne Mullin. Cole is Chickasaw and Mullin is Cherokee. (Previous: Rancher, businessman, and yes, absolutely, a career politician.)

Now another Cherokee Nation tribal member, Tahlequah Mayor Jason Nichols is challenging Mullin. (This would be a first if both win primary contests: Tribal members on both sides of a congressional ballot.) Nichols is running as a Democrat.

Nichols told the Tahlequah Daily Press that he’s running because of the dysfunction in Washington.  “I’m accustomed to operating in a nonpartisan environment where ideas and practical considerations are the focus of discussions,” he said. “As the mayor of a small town, you have to look your constituents in the eye every day. That’s kept me grounded and reminded me there are real people affected by every decision I make, to never lose sight of that, and to make certain I stay connected with them and never forget whom I work for. That isn’t a political party.”

Nichols is a political science instructor at Northeastern State University and has worked as an information technology officer for a tribe and a school district.

That’s it. We’re off and running. More politics ahead. Watch for the hashtag, #NativeVote18.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com

 

Screenshot 2017-08-23 09.13.04.png
Interactive map and spreadsheet of #NativeVote18 candidates. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did you hear the one about the Senator raising concerns about Indian health?

Screenshot 2017-07-26 06.41.18.png
Sen. John McCain votes yes on the Senate’s Motion to Proceed, then attacks the process, only to vote yes on the first bill that failed his test of regular order. Quite a day. (Photo via Senate video)

Mark Trahant / Trahant Reports

The Senate is now going through 20 hours of debate on a House Resolution 1628 to repeal and replace the Affordable Care Act. But the House bill was stripped of every word except the title. Now the idea is to come up with the right language to reach 50 votes (so when like the Motion to Proceed, Vice President Mike Pence can break the tie and vote yes).

The first proposal, Senate Amendment 267, had all sorts of problems on the floor. The Senate’s Parliamentarian ruled that parts of the bill did not get a score from the Congressional Budget Office and other parts violated budget rules. So 60 votes, not 50 were needed for this version to pass. But the Republican leadership wasn’t even close to 50 votes — Nine Republicans voted against it.

Including Arizona Sen. John McCain who just a few hours before said he wasn’t happy with any of the legislative proposals. Think about this. He interrupted his cancer treatment (taxpayer funded health care) then gave a stirring speech about the break down of civility in the Senate. He said he would vote against the bills as presented, and then, votes yes anyway. Quite a day.  And so much for his words. I’ll admit: I thought McCain meant what he said.

Then at least McCain earned respect and praise from President Donald J. Trump. He tweeted: Thank you for coming to D.C. for such a vital vote. Congrats to all Rep. We can now deliver grt healthcare to all Americans!”

Screenshot 2017-07-26 06.34.31.png

Screenshot 2017-07-26 06.50.10.png

Now that’s something — as is the process itself.

This week’s Senate debate on TV will be exciting. Seriously. There will be many hours ahead of members speaking to an empty chamber about why the Affordable Care Act works — or why it should be repealed. (And lots of images of staff shuffling papers on camera.) Great theater, right? Then every once in a while (about the time paint dries) there will be a call for a vote and the dramatic calling of each senator’s name for a vote.

There are two main versions that will surface soon. The first is a repeal — or at least as much of a repeal as possible with 50 votes — that’s been proposed by Sen. Rand Paul, R-Kentucky. That proposal has little chance.

Then later in the week, Senate Majority Leader Mitch McConnell, R-Kentucky, will propose an amendment that they’re calling a “Skinny Repeal.” It would eliminate some taxes, a few more regulations, but leaves Medicaid alone. It’s supposed to be something for both moderates who want to leave Medicaid alone and for conservatives who want a repeal. Ha! And remember: If this version passes the Senate the bill will move to a conference committee with the House. That’s where the Medicaid cuts will come back. This is a phony negotiating plank.

As the debate unfolds, the Senate is in a way making the case for why we need Native Americans in the legislative process. There will be all kinds of talk about what the law does to Americans, to the poor, to taxpayers, to just about every constituent group in America. What’s really needed though is for one Republican senator to explain about the Indian Health system and what havoc all of these proposals would wreak. (Last week several Democrats did just that.) One majority party senator could say the Indian Health Service has never been fully funded, despite treaty promises, so why strip millions of dollars away? Or ask about Indian children when more than half are covered by Medicaid. Or show why Indian Country needs the jobs that have been created (and will be lost) by these proposals. Better yet: One Native Senator could use data to prove that Medicaid works.

Indian Country deserves to be in this debate. Alaska Sen. Lisa Murkowski has been a key opponent of the Republican leadership’s health care legislation. It’s mostly about Medicaid. I am sure that it’s also due to her support of the Alaska Native medical system. She gets it.

But Murkowski will pay a political price for her votes, at least in a primary election. But then she’s gone through that before. And won.  Not long after the Senate vote on the Motion to Proceed, the Alaska Republican Party said Murkowski abandoned them. Party chairman Tuckerman Babcock said the “repeal of Obamacare is non-negotiable.” (Funny: I feel the same way about the Senate alternatives.)

And so the party talks about possible consequences for Murkowski. Babcock said her vote put at risk new oil drilling in the Arctic National Wildlife Refuge (would that be true) and said her Energy Committee “chairmanship could be at risk.”

And President Donald J. Trump tweeted Wednesday morning: “Senator of the Great State of Alaska really let the Republicans, and our country, down yesterday. Too bad!”

So will there be punishment? I would not be so sure. Remember the Republican majority is thin. As I reported last week: Three senators switch sides and it’s a new Senate.  Two are already really, unhappy. So the way to make it three is for Republicans to continue to attack their own members.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com

 

 

Senate is blind: Healthcare vote minus a draft, public hearings, or common sense

Screenshot 2017-07-23 08.05.39.png
Senate Majority Leader Mitch McConnell (R-Kentucky) and whip John Cornyn (R-Texas) brief the press on the upcoming vote on a repeal and replacement for the Affordable Care Act. (Photo via McConnell Press Office on Twitter.)

Mark Trahant / Trahant Reports

Here we go again. Another week and the United States Senate is ready to vote on legislation to remake the entire healthcare system, including Indian health. The Senate will do this without a draft circulated for debate, public hearings, or common sense.

So what does the replacement bill look like at this point? I have no clue. Neither do the 100 senators who will make that call. As Sen. John Cornyn (one of the managers for the bill) put it: Knowing the healthcare plan ahead of the vote is a “luxury we don’t have.”

Here is what President Donald J. Trump tweeted over the weekend: “The Republican Senators must step up to the plate and, after 7 years, vote to Repeal and Replace. Next, Tax Reform and Infrastructure. WIN!”

Screenshot 2017-07-23 06.19.54.png

So there will be a vote on legislation to at least repeal the Affordable Care Act. “We have decided to hold the vote to open debate on Obamacare repeal early next week. The Obamacare repeal legislation will ensure a stable, two-year transition period, which will allow us to wipe the slate clean and start over with real patient-centered healthcare reform. This is the same legislation that a majority of the Senate voted to send to the president in 2015. Now, we thankfully have a president in office who will sign it. So we should send it to him,” said Sen. Majority Leader Mitch McConnell, R-Kentucky.

But a straight repeal is complicated by Senate rules. The Senate Majority Leader is relying on the process of reconciliation (essentially matching the legislation to an existing budget) because that only requires a majority, or 50 votes. Most bills need 60 votes to stop a filibuster. Last week the Senate parliamentarian, Elizabeth MacDonough, said that defunding of Planned Parenthood, abortion coverage, and restrictions on insurance coverage does not meet that test and still required 60 voters. Same thing for the Alaska or rural exception, it’s a no go. But Senate Republicans were quick to say that any draft language (which is still missing from action) could be rewritten. Or Republicans could overrule the parliamentarian on the floor which would cause all sorts of future problems governing.

The Senate’s parliamentarian is a great example of the institutions of Congress pushing back on the Republican proposals. I don’t think it’s ideology; it’s incompetence. (As I have written before there is a conservative approach to healthcare reform, but we have not seen that yet.) The Congressional Budget Office said last week that the big ticket in this debate is Medicaid. Remember the proposals in the House and Senate go far beyond just repealing the Affordable Care Act because the proposals would fundamentally restructure Medicaid.

According to CBO: “By 2026, spending for that program would be reduced by 26 percent … About three-quarters of that reduction would result from scaling back the expansion of eligibility enacted in the Affordable Care Act (ACA). In 2026, for people who are made newly eligible under the ACA (certain adults under the age of 65 whose income is less than or equal to 138 percent of the federal poverty level [FPL]), Medicaid spending would be reduced by 87 percent, from $134 billion to $17 billion—mainly because the penalty associated with the individual mandate would be repealed and the enhanced federal matching rate for spending on that group would be phased out. As a result of the reduced matching rate, some states would roll back their expansion of eligibility and others that would have expanded eligibility under current law would choose not to do so. All other federal spending on Medicaid in that year would be reduced by 9 percent, from $490 billion to $447 billion.”

This is what pays for the tax cuts in the Republican plans.

Rolling back Medicaid expansion and the traditional Medicaid program would significantly reduce funding for the Indian Health Service.

Last week the National Indian Health Board, the National Congress of American Indians, and the National Council of Urban Indian Health, wrote McConnell because one of the Senate bills, the Better Care Reconciliation Act of 2017, would change the formula for funding Indian health patients. The three intertribal organizations call the proposal a “radical departure from over 40 years of federal policy” and it “should not be undertaken without nationwide tribal consultation.” The bill’s language reverses a policy where states get a 100 percent reimbursement for patients who get services from the Indian health system. This change, the intertribal organizations said, would “ take away this unique incentive for states to work with tribes to create Medicaid innovations that best support the Indian health system.” States could create new rules that could ignore Indian health as a partner and create new barriers that would sharply reduce funding.

North Dakota Sen. John Hoeven, who is chair of the Senate Indian Affairs committee, said the changes would provide “more choice and competition in our health care system, while at the same time insuring that low-income individuals have access to healthcare coverage” via Medicaid or tax credits.

The key thing here: Native Americans could take their insurance (and the state Medicaid dollars) to another provider, reducing funding for IHS. (Competition, you know.)

It would be one more costly strike to an Indian health system that’s already underfunded.

Hoeven said a draft Senate bill also would end the requirement that tribes purchase insurance for employees. Again, the result would be less money for the Indian health system. (And, as the three intertribal organizations point out, this would be done without any tribal consultation.)

Then again the Senate and House bills are designed to strip money from the health system period. And Medicaid is such a rich target. The Kaiser Family Foundation estimates the total cost to states under the Better Care bill is $519 billion.

Screenshot 2017-07-23 07.56.11.png

Back to the math and this week’s vote. There are 100 members of the Senate. The 48 Democrats are certain to vote no. And of the 52 Republicans, it’s unlikely Sen. John McCain would leave his cancer treatment in Arizona to vote on a motion to proceed (the opening of the debate and the consideration of amendments). That leaves 51 votes. Sen. Susan Collins of Maine is a certain no because she objects to the attacks on Medicaid. That reduces the number to 50 (and 49 no votes). There are lots of questions about Senators Lisa Murkowski of Alaska, Rob Portman of Ohio, and Shelley Moore Capito of West Virginia. Capito tweeted: “I will only vote to proceed to repeal legislation if I am confident there is a replacement plan that addresses my concerns.” And Portman said he’ll review whatever bill comes up for a vote. Murkowksi told CNN: “I don’t think it’s asking too much to say give us the time to fairly and critically analyze these numbers. And if you say, well, CBO numbers don’t matter, let’s look at the numbers that you don’t think matter. But it really does make a difference. And these numbers that we’re talking about, these are men and women, these are our families that are being impacted. So let’s please get it right.”

Does that sound like three no votes? Right now, I’d only count all three as firm maybes. Then only one needs to be the no.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com

 

 

The Alaska Fix: How the Senate could fix healthcare & govern in the Trump era

LAM edit.jpg
The Senate is broken. Sen. Lisa Murkowski (who has already lost a primary only to win a general election) should consider The Alaska Fix for the good of the country. Three senators could put the Senate under new management (like the Alaska House of Representatives). (Senate photo)

Mark Trahant / Trahant Reports

The Senate is broken. Republicans control 52 seats only part of the time. Enough votes to win a majority and pass a judicial nominee. But not enough votes to fix the healthcare legislation sent up by the House. Or, more important, not enough votes to govern. Watch that problem grow on issues ranging from the federal budget to raising the debt limit.

The latest plan is a doomed vote on healthcare. Majority Leader Mitch McConnell told reporters that “as of today we simply do not have 50 senators who can agree on what ought to replace the existing law.” His response is to demand a vote to repeal the Affordable Care Act with a plan to pass a replacement bill later. The old kick-the-can-down-the-road approach. But first a vote — and already at least three senators have said they will oppose a motion to proceed so there will not even be a debate.

The Senate will be on record. And we will know which Republicans are more loyal to their party than the country. Then, the thinking goes, Republican voters could punish those members next election with primary challenges. (Already the White House is shopping for a candidate to run against Arizona Sen. Jeff Flake.)

This is governing in the Trump era. Make that, this is not governing in the Trump era. The twist in this story is that the majority of the Senate wants to work together, find common ground, and move on. The majority in the Senate could pass a budget. A majority in the Senate would raise the debt limit. And, most important, the majority of the Senate would act as a constitutional check on the executive branch.

This is actually what senators say they want. And get this: More than 70 percent of the public want bipartisan cooperation, according to a new Kaiser Family Foundation poll. Even 46 percent of Trump supporters say “they want to see Republicans work with Democrats to improve the Affordable Care Act — statistically tied with the 47% who would rather see Republicans continue working on their own plan to repeal and replace it.”

Meanwhile the White House is blaming Democrats for the failure to get 52 Republican votes. (Logic be damned.) And President Trump’s is again saying just let Obamacare fail (with his management help). He said: “It will be a lot easier. … We’re not going to own it. I’m not going to own it. I can tell you the Republicans are not going to own it. We’ll let Obamacare fail and then the Democrats are going to come to us.”

Same story from Republican leaders across the board. McConnell has used “working with Democrats” as kind of a threat. The message is GOP loyalty is more important than governing.

Enough.

The Senate could get back on track by picking up a lesson from Alaska: Choose to govern.

The Senate could function again if the majority — Republicans and Democrats — came together to lead. This is how it works in the Alaska House of Representatives; a governing caucus brings together 17 Democrats, 3 Republicans, and 2 independents.

A new Senate independent bloc could work the same way.

It would only take 3 Republicans to make it so. They’d join all of the Senate’s Democrats and independents to run the show. You could start with Senators Lisa Murkowski of Alaska, Susan Collins of Maine, and, since he’s so unpopular at the White House, Jeff Flake from Arizona. Either Murkowski or Collins would make a fine Majority Leader. (Yes, there will be retaliation from Republican loyalists. But even that might not work. Murkowski already knows what it’s like to lose a Republican primary only to win the general election.)

The Senate would be the counterweight to a Trump administration out of control.

This would mean new committee chairs, including Democrats. Imagine Patty Murray in charge of heath care legislation.  Or Bernie Sanders calling the shots on the budget. And Indian Affairs would be chaired by Tom Udall. A new day.

There is precedent. In 2001 the Senate was divided equally among Democrats and Republicans. The leadership went to Republicans because Richard Cheney was Vice President and could cast the deciding vote. But in May 2001 Vermont Sen. James Jeffords switched from Republican to Independent. One Senator flipped control from the Republicans to the Democrats in the middle of a session.

Jeffords’ obituary in The New York Times put it this way: “As chairman of the Education and Labor Committee … he had become frustrated by what he viewed as Republican parsimony.” As the dictionary puts it parsimony is cheap to the point of stinginess. True today. But then, like now, Republicans weren’t serious about governing. So for the good of the country — politics be damned — Jeffords placed the Senate under new management.

It’s time for new management in the Senate.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com

 

 

And just like that … it’s back to square one for healthcare, budgets and taxes

Screen Shot 2017-07-18 at 4.45.38 AM.png

Trahant Reports

So the Senate (and therefore the House) plan to repeal the Affordable Care Act, destroy Medicaid as we know it, and shell out billions in tax cuts for the wealthy is no more. Monday night Utah Sen. Mike Lee and Kansas Sen. Jerry Moran said they would vote against even debating the Senate healthcare bill. So it was defeated by unanimous opposition of Democrats, the Senate’s most conservative members, and Republican Maine Sen. Susan Collins who opposed the Medicaid cuts.

“Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful,” McConnell said. “So, in the coming days, the Senate will vote to take up the House bill with the first amendment in order being what a majority of the Senate has already supported in 2015 and that was vetoed by then-President Obama: a repeal of Obamacare with a two-year delay to provide for a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care.”

So plan B, supported by President Donald J. Trump, is a repeal of the Affordable Care Act without a plan to figure out what a replacement looks like. Trump tweeted: “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!”

IMG_2688.jpg

IMG_2687.jpg

But that will not be easy either. The idea of a repeal without a plan is crazy when you’re talking about such a huge chunk of the economy. And many Republican senators have already said so. As I have been writing (often) the problem is that the Republicans do not have a governing majority.  They are split. Hopelessly. They really needed their healthcare bill (something they all campaigned on) as a glue to keep their coalition together. Now it gets tougher.

There are practical problems with a “just repeal” approach too. The Senate language has to be narrowly drafted on fiscal issues in order to meet the test of a budget reconciliation bill. This process is arcane but it eliminates any filibuster by Democrats. It also means there will be no outright repeal (which would require 60 votes to stop the filibuster) just the budget applications of the Affordable Care Act. Complicated, right? The budget the Senate is working off of requires a billion dollars in savings from any repeal.

Even this will be tricky. First there will need to be consensus for a new vote to bring up the House bill. (It’s called a Motion to Proceed.) That measure would be open to amendments, including the repeal provision. (The president must have just been informed about this problem. He tweeted: “The Senate must go to a 51 vote majority instead of current 60 votes. Even parts of full Repeal need 60. 8 Dems control Senate. Crazy!”

That’s just one of the crazy, sticky issues for a repeal amendment (not to mention any other amendment that surfaces). Language that would lift the individual mandate to purchase insurance could also eliminate coverage for pre-existing conditions — and doing that would make health insurance unworkable for the companies. This could cause widespread market panic.

Depending on how it’s written, an outright repeal could impact Indian Country because it could include the Indian Health Care Improvement Act. The Senate and House plans were careful to sidestep that issue. This is a blank slate. A political danger zone.

However the Senate’s political implosion also shows how difficult it will be for the House and Senate to pass a budget, lift the debt ceiling, and get on with other important work.

Screen Shot 2017-07-18 at 5.20.15 AM.png

The House released its budget plan Tuesday morning and it sets its course for using the reconciliation process too. (In theory: Life is so much easier if you don’t need votes from Democrats.) That budget bill will be marked up on Wednesday and it will be tough to win a majority of Republicans. It has every controversial Trump project included, money for a border wall, cuts to social welfare programs, including Medicare. Some Members don’t like the increases in military spending coupled with sharp budget cuts for domestic programs, more than $200 billion worth. (It will be up to committees to figure out where the cuts would happen.) Other Members think there ought to be more cuts. And to make this process even more complicated, the House budget includes tax provisions. That only makes the task ahead more difficult.

Buckle your seat belts. — Mark Trahant

 

 

 

 

 

Senate Republicans will have to wait for John McCain to return after surgery

Screen Shot 2017-07-16 at 7.48.46 AM.png

When every senator could be the 50th vote, any one absence means no healthcare bill

Trahant Reports

The Senate healthcare bill looked like it was going to pass on Friday. There were only two public no votes (when three are needed to defeat the measure.) And you can only imagine how much pressure leadership was putting on its members to vote yes for the good of the party. This bill was (and is) a priority for the Republican leadership and the White House.

But over the weekend things changed. Sen. John McCain’s office announced that the senator had surgery for a blot clot over his eye. “Senator McCain received excellent treatment at Mayo Clinic Hospital in Phoenix, and appreciates the tremendous professionalism and care by its doctors and staff. He is in good spirits and recovering comfortably at home with his family. On the advice of his doctors, Senator McCain will be recovering in Arizona next week.”

Now the Senate cannot vote on the healthcare bill. There is no way to get to 50 votes without him. So Majority Leader Mitch McConnell will wait until McCain heals. At least a week.

That means there is a lot more time for the opposition to make its case. On Monday or Tuesday there will be a new Congressional Budget Office score of the bill. And that could be followed by some kind of alternative review from a federal agency. Think fake news but in a government document.

Another Not So Good for the Senate Bill moment was a letter from health insurance companies that said the Cruz amendment is unworkable in any form. The problem is that healthy people will buy cheaper plans leaving those who are already sick to buy the ones preserved from the Affordable Care Act.

State governors also remain opposed to the Senate bill. Vice President Mike Pence attempted to change their minds. He spoke as a former governor who accepted Medicaid Expansion, but now says the Senate bill is all about freedom to redesign health insurance. “And if you take nothing else from what I say today, know that the Senate healthcare bill gives states the freedom to redesign your health insurance markets.  And, most significantly, under this legislation, states across the country will have an unprecedented level of flexibility to reform Medicaid and bring better coverage, better care, and better outcomes to the most vulnerable in your states.”  He argues that the Medicaid reforms will secure “Medicaid for the neediest in our society.  And this bill puts this vital America program on a path to long-term sustainability.”

But, as I said, the governors didn’t see the issue the same way. Democrat and Republican sees the numbers and now that the Senate bill will result in substantial budget cuts lasting more than a generation. (In fact: One of twisted messages from McConnell to moderate Republicans is don’t worry. The cuts down the road will never happen.) This bill would destroy the Medicaid that we have now. Including the money that helps fund the Indian Health system.

Looking for background? Here are recent pieces on the Senate health care bill and its impact on Indian Country: The special deal for Alaska; Lies we’re being told about budget cuts; The impact on jobs in Indian Country; Trump tells tribal leaders Medicaid cuts will be good; and health care policy is a debate worth having (but this is not that.)

 

 

 

 

Election update: Rancher, businessman, and, yes, absolutely, a career politician

Screenshot 2017-07-11 09.13.17 (1).jpg

Mark Trahant / Trahant Reports

Last year about now I was pretty much writing all politics all the time. Indian Country had so many good candidates to offer. Interesting resumes. Better ideas. Campaigns that led to a few wins. A few more losses. And that’s life.

This year I am pretty much writing about health care policy all the time. The Republican plans are so bad — and especially for Indian Country — that they ought be dismissed as dangerous nonsense at every opportunity. As I have written before there is a conservative approach to health care. None of the current proposals are that; they are only a destructive force. (More about that after the Senate releases it latest attempt to reach a 50 vote majority.)

Of course there is also a connection between campaign politics and policy. We’re almost a year away from the next House and Senate election and we’re just starting to get a look at the candidates who will be making policy.

And it turns out there is news.

In Oklahoma, Democrats swept two state legislative seats this week in districts where Donald Trump won handily last year.

One of the seats in the Tulsa area had been held by Rep. Dan Kirby, Creek, and a Republican member of the Native American caucus. He resigned in February following allegations of sexual harassment by staff members. Kirby’s seat was won by a retired teacher, Karen Gaddis (who lost to Kirby in November by 12 percentage points). This had been a safe Republican seat.

A state Senate election (also stemming from a sex scandal) was won Tuesday by a Democrat in the Oklahoma City area.

Oklahoma is one of the most Republican states in the country. So it’s huge to see such a significant shift in a special election. (Unless, that is, it’s just those sex scandals and not the Trump factor.)

One person who ought to be especially concerned by these two election results: Rep. Markwayne Mullin.

Mullin won 70 percent of the vote in his third re-election bid in 2016. Mullins, a member of the Cherokee Nation, first ran in the Tea Party-inspired wave in 2012. He ran against too much government, a repeal of Obamacare, and a silly promise to limit his time in office to three terms.

Now he’s running for his fourth term and some prominent conservatives are unhappy. Former Sen. Tom Coburn told Oklahoma’s KFAQ radio that it was sad because this “nice young man … has drunk the Kool-Aid in Washington.”

It’s funny and prescient. Mullin’s ads said: “A Rancher. A Businessman. Not a politician.” Mullin can hardly say that now. It’s like the great line in the movie “The Candidate” when young Bill McKay is elected governor and his father (who was a governor) tells him: “Bud, you’re a politician.”

Even the story changed. In his early ads, Mullin talks about term limits as an answer to the problem of being an insider in Washington. But in his video explaining why he’s running again, Mullin said — after much prayer — that he’s changing his mind for family reasons. “I’m not hiding from that because we did say we’re going to serve six years, and it was out of true concerns,” he said. But that’s ok now. The family is doing great.

And, like every politician before him, the voters really need him. Just him. Especially during this era of Donald Trump (that is … if the era even lasts until the next election).

Mullin has been the congressional voice for the Trump version of a Native American policy. He praised the Dakota Access Pipeline project and was critical of tribal leaders for opposing it at a hearing in February. “What do you consider meaningful conversations between government-to-government?” Mullins asked Chad Harrison from Standing Rock. His reply was great: “An actual dialogue, perhaps.”

But while Mullin complained about the power of Standing Rock to slow down the Dakota Access Pipeline, he says he’s all for increased powers of tribes to develop such energy projects. The president should “provide tribes with the resources they need in order to best decide how their land should be developed,” he said. How. Not if.

Then perhaps that gets to the actual dialogue part. Or lack thereof.

Mullin supports the House health care bill that would wreck the Indian health system. Then Mullin does not see it that way. In a May Q & A published by the Miami News-Record he said flat out that Republican plans will not hurt the Indian Health Service. “The American Health Care Act (AHCA), which the House passed on May 4th to repeal and replace Obamacare, makes no changes to Indian Health Services (IHS). In addition, the spending bill passed to fund the government through September funds IHS at a rate of $5 billion – an increase of $232 million from last year’s levels. I anticipate the native people of Oklahoma will welcome both of these things.”

Excuse me. But as I’ve been reporting (often) Medicaid is a significant funding stream for Indian health. And the House bill (and its Senate twin) destroy that whole infrastructure.

He told his constituents that no one who has health care will lose it because of the Republican plans. He said emergency rooms cannot turn people away. Seriously. That’s a health care plan? Mullin told the Tulsa World: “We think the federal government is going to solve all of our problems, but let me ask you, how is (that) going?”

That explains a lot. Mullin was against the Violence Against Women Act (which will need to be reauthorized by Congress next year) including the provisions that recognize tribal judicial authority.

Back to politics. If there is a voter groundswell of Trump opposition — even in Oklahoma — then Mullin’s re-election race could become interesting. The right candidate could push him on the left while Coburn and other conservatives will question his integrity from the right.

But who will challenge him? I’d like to see a candidate from one of the tribes. Oklahoma’s 2nd Congressional District is 17 percent Native American and it’s 65 percent rural. That’s two constituent groups that will be deeply impacted by Republican health care plans. There is an issue to run on here. (Not to mention that Coburn, who once held this seat, will campaign against Mullin. And the Trump chaos.)

We’re a little more than a year away from the next election. So this is the time to sort out who’s running from Indian Country, who should be running, and to pass on those candidates who regularly vote against Indian Country. I’d add Mullin to that last list.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com

 

Trump tells tribal leaders that Medicaid cuts will be ‘great for everybody’

Screen Shot 2017-06-29 at 6.28.02 AM.png
President Donald J. Trump meets with tribal leaders for Energy Week. He calls the Medicaid cuts will be great for everybody. (White House photo via YouTube.)

Senate bill ‘mostly dead,’ but will it revive after break?

Mark Trahant / Trahant Reports

The Senate’s health care bill is “mostly dead.” But that’s not the same as all dead. And this holiday weekend will decide either the legislation has a second life or if there is a better way to proceed.

Republican Senate Majority Leader Mitch McConnell is planning another shot at health care reform (excuse me, a plan to cut taxes and roll back Medicaid) this week producing yet another draft of the health care bill. Meanwhile Senators (as well as members of the House) will break and return to their home districts. This is where the people have a chance to weigh in with a “hell, no!” The Senate bill may be the most unpopular piece of legislation ever, currently earning support of between 12 and 17 percent depending on which poll you read. To borrow the TSA phrase, if you see someone (as in a member of Congress) say something.

Consider this: Medicaid is popular across the board. A poll by Kaiser Health News illustrates this point. It shows that some three-fourths of Americans view Medicaid favorably. (But the poll also points out that most Americans don’t know that both GOP bills would cut deeply into the popular program.) Even Republicans think Medicaid works.

For the past few weeks I have been writing post after post about how bad this approach to health care — I mean, tax cuts — is as a policy. The problem is basic. Many Republicans do not believe health care is a right. So it’s their mission to roll back government. But not every Republican believes that. Some see the effectiveness of programs such as Medicaid and see it’s rollback as unconscionable. (Previous: Health care deserves policy debate.)

DDakaygXsAEYwzK.jpg-large.jpeg
Recent polling from Kaiser Family Foundation shows support for Medicaid across the political spectrum.

 

At a meeting with tribal leaders at The White House, President Donald J. Trump was asked about cutting Medicaid. His answer: “It’s going to great.  This will be great for everybody.”

Read “great” as “clueless.” But the president did say it was going to be difficult to get the votes, “it’s very tough …  I think we’re going to get at least very close, and I think we’re going to get it over the line. ”

We shall see. Mostly dead or all dead? And an all dead GOP health care bill could deliver a miracle.

This is the moment where McConnell will pull out his checkbook. He will be trying to win *cough* buy * cough* support from senators with sweet deals for the folks back home. If that doesn’t work, McConnell said he might be forced to work with Democrats on legislation. Imagine that! A Congress that works with both parties.

This is what really ought to happen. The Affordable Care Act has problems that need to be fixed. But it’s in specific areas, such as the individual insurance market, and a bipartisan approach would actually yield the best results.

But more important the only way that Congress governs again is for leadership to recognize that they cannot govern with Republican votes alone because they don’t have enough votes. There is a split within the Republican Party on the very question of health care as a right, let alone specifics about how much to cut and where.  And that same division plays out on just about every major public policy issue.

But a few Republicans working with Democrats do constitute a majority in both Houses. A lot could get done. The Congress could pass a budget. Raise the debt limit (averting another crisis) and do the jobs that we the people hired them to do. That would take a miracle right? But we can always hope and the first step is an all dead Republican health care bill.

How long will it take for this process to unfold? This will only happen when congressional leaders run out of options and see working with Democrats as the only path forward. This will take time because as Miracle Max said in The Princess Bride: “You rush a miracle man, you get rotten miracles.”

We don’t need another rotten miracle.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com

 

 

 

 

 

 

 

Trump Reality Show is unbelievable, but hides the real off-screen Medicaid attacks

18556519_1317898564964540_773817119274250156_o
The best moment for the new Trump Administration was the one where the president smiled in Saudi Arabia and said only 26 words in public. This was terrible reality TV but we all watched knowing that it was likely just a pause. Something outrageous must be coming up next. Meanwhile, beyond the distraction, Republicans work to dismantle the most successful government health insurance for the poor, Medicaid. (White House photo)

 

 

Mark Trahant / Trahant Reports

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.

Screenshot 2017-05-21 08.55.46.png

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.”

And, as Paradise notes in the recent report, “10 Things to Know about Medicaid: Setting the Facts Straight,” evidence continues to mount that Medicaid improves health outcomes. This is especially true when it comes to detecting and treating diabetes, mental health programs, and research has found that Medicaid expansions for adults were associated with significant reductions in mortality.

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.

 

 

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com

 

 

Health care is now the Republican’s mess and it will define the 2018 elections

Screenshot 2017-05-04 16.54.23.png
President Donald J. Trump and House Republicans celebrate their legislative win, the passage of the American Health Care Act. The bill now moves to the U.S. Senate where it will be considered and likely amended significantly. (White House photo via YouTube.)

 

Mark Trahant / Trahant Reports

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.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Reposting or reprinting this column? Please credit: Mark Trahant / TrahantReports.com