It would be cool, just this once, if the Senate would say, “Indian Country you are so important. So we are adding a special provision to this health care bill that adds big bucks to the Indian Health Service.” Then Senators with significant American Indian or Alaska Native populations would shift their votes from perhaps to yes.
That might sound like a fantasy. But it’s the track that the Alaska delegation is on; senators secured a special deal in the Senate health care plan for their state. Only it’s not about Alaska Natives. And it’s not nearly the same amount of dollars that the state will lose with Medicaid cuts (or, for that matter, in high cost insurance.) But it’s a “victory” of sorts that will be claimed if Sen. Lisa Murkowski eventually votes yes on the Senate bill. (Sen. Dan Sullivan was a likely yes, anyway, although he’s claiming credit too.)
Here’s the deal. The legislation includes a complicated formula to reduce Medicaid spending — except in states with a population density of less than 15 people per square mile. That’s Alaska, Wyoming, North and South Dakota, and Montana. New Mexico just misses but then it’s a Blue state and its senators would likely vote no anyway. And, the exception might be of use to Sen. John Hoeven from North Dakota but, like Sullivan, he probably would vote with leadership anyway.
So really it’s about Alaska — and Murkowski’s vote. She’s a firm maybe. So far three senators have said no (enough to kill the bill) but we won’t know how solid those no votes are until there’s an actual vote. The self-proclaimed no votes are Sen. Susan Collins of Maine, Rand Paul of Kentucky and John McCain of Arizona. (Republicans need 50 votes from their own party.)
The rural exception to the Senate bill adds up to just under $2 billion, according to The New York Times.
But special deal or not, the big picture might be more important to Murkowski.
Alaska is a state where the evidence is strong that the Affordable Care Act and Medicaid Expansion are working. Nearly a quarter of the state’s population is enrolled in Medicaid and the state’s 2015 expansion added more than 34,739 people. Half of the state’s children are insured by Medicaid.
And, of course, Medicaid is an essential revenue source for the Alaska Native medical system — a system that Murkowski praised just this week at a hearing on the Indian Health Service.
A study done for Alaska’s Department of Health and Human Services — run by Commissioner Valerie “Nurr’araaluk” Davidson — is blunt. It says: To stay under a per capita cap Alaska would be required to cut its Medicaid program spending by $929 million in federal and State dollars between FY 2020 and 2026, with a federal funds loss of $473 million … The magnitude of the federal cuts are such that they may well affect Alaska’s ability to finance other State priorities such as education and infrastructure.”
The report says the cap will not include patients in the Indian Health system, but that Alaska will have to cut back on eligibility to reduce Medicaid spending.
Analysis of the House plan (remember at some point the House and Senate bills would have to be merged and passed again) would cost Alaska $2.8 billion in Medicaid funds between 2020 and 2026.
What’s even more problematic: “Alaska will have to establish its Medicaid budget almost two years before it knows the amount of federal Medicaid funding available for that budget year.” That could result in a “claw back” effect where money has to be returned to the federal treasury after its already spent. The impact of the Senate bill would be quick. The state’s report estimates that within three years a quarter of all Medicaid funding would be eliminated. And, more important, by 2022 95% of expansion enrollees will have lost coverage due to Alaska’s highly seasonal workforce.”
So will the rural exception be enough to buy votes? It’s certainly not enough funding to maintain Alaska’s successful Medicaid Expansion.
A Senate hearing Wednesday on Indian health illustrates the larger problem exactly: How can you strip millions of dollars from a health care system and get better results?
The answer is you cannot.
But that’s not what the Trump administration testified. And it’s not what the Senate leadership is saying about its health care bill. Or the House for that matter.
So they lie. And it’s a lie that is so bold, so outrageous, that it should not told with a straight face. There is no defense. That’s why doctors, governors, hospitals, patients, economists, policy-makers, anyone willing to tell the truth about the destructive nature of these so-called health plans are in the opposition. A recent USA TODAY/Suffolk University poll shows the support for the Senate plan by only 12 percent making it one of the most unpopular bills ever.
And yet the Senate bill is still on the table. A new bill is out today and a vote could come as soon as next week. President Donald J. Trump told a Christian television show that he would be “very angry” if this bill fails. “I am sitting in the Oval Office with a pen in hand, waiting for our senators to give it to me,” the president said. “It has to get passed. They have to do it. They have to get together and get it done.”
Let’s start with the hearing on Capitol Hill Wednesday. Rear Admiral Michael Weahkee, the acting director of the Indian Health Service, testified about the agency’s budget to the Senate Appropriations Subcommittee on Interior, Environment and Related Agencies, chaired by Alaska’s Sen. Lisa Murkowski. “I am pleased to provide testimony on the President’s Fiscal Year (FY) 2018 Budget Request for the IHS, which will allow us to maintain and address our agency mission to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives (AI/ANs) to the highest level,” began his written statement. It gets better: “The Budget reflects the Administration’s high priority commitment to Indian Country, protecting direct health care investments and reducing IHS’s overall program level by only 0.9 percent when compared to the Annualized Continuing Resolution, in the context of an 18 percent reduction within the overall HHS discretionary budget.”
In other words we’re cutting the hell out of all budgets — so be happy with your cuts Indian Country.
So what if the words “maintain” and “raise” don’t fit with the highest level of health care. It’s no secret that Indian Health is already underfunded.
The measure of that shortage that makes the most sense is to compare spending by IHS to what’s spent by the federal government on federal employees. According to the National Congress of American Indians that measure shows IHS funding at about 60 percent of need.
(Of course you could argue that the U.S. health care system is too expensive. But that’s a different conversation. Reform is not even on the table right now. This whole fight is just about money; money for health care or tax cuts.)
The problem with the Senate hearing and a recent Wall Street Journal article on the failure of the Indian Health Service in the Great Plains is that the Indian Health Service is not what it was. It’s no longer just a government health care agency. In fact most of the agency is a funding mechanism for tribal and non-profit health care facilities. The congressional oversight needs to be re-imagined to fit both of these missions.
The Journal stories highlighted operational issues in South Dakota and Nebraska that demonstrate a tragic failure. (This is the IHS story most of us already know.) And after years of warning the agency has not come up with a strategy to effectively fix its own management.
“Because this is our IHS. These are our facilities that are supposed to care for our first people,” Sen. Murkowski said. “And the stories that were detailed were shocking.”
But Sen. Murkowski correctly identified the division within IHS. She told Alaska Public Media that Alaska’s Native health facilities are run by tribes, under contract to the IHS, so their problems aren’t the same. True. But that’s more than half of the system. That’s the story that the Journal did not tell (and do the reporting about why tribes and non-profits are able to deliver better care than the agency itself.)
The answer, in part, take us back to the larger Senate debate. The Alaska Native Medical Center has balanced funding: Money from IHS, aggressive third-party billing from private insurance and especially Medicaid as well as foundation grants. This kind of balance ought to be the future (unless Congress says, “well, let’s fund Indian health at 100 percent of need”) for others across Indian Country.
That’s why the narrative of failure is problematic. It’s true that there is a systemic crisis — especially in the Dakotas. So much so that Montana Sen. Steve Daines has even suggested changing the name of IHS to “Indian Health Suffering.” Old story.
But that’s why there should also be a narrative of success. I, too, would change the name of IHS, but to the Indian Health System. Because parts of that system are excellent and ought to be a model for health care, period.
And that’s where Medicaid comes into the picture. At the Senate hearing there was frustration because IHS did not provide enough data.
The IHS budget calls for $1.2 billion in third-party billing. Most of that is Medicaid. That will work for next year. But it’s important to remember the House and Senate plans will cap and reduce what is spent on Medicaid. Right now: If a person is eligible, the money is there. Under the GOP alternative there will be a set amount of some kind. The money will run out.
But IHS officials did not talk about Medicaid much. And Montana Sen. Jon Tester pointed out: “I think it’s absolutely unbelievable that you can’t separate how much Medicaid has helped your with third-party billing.” This is is what we need to know.
The Indian Health Service operates in both Medicaid and Medicaid expansion states. Remember not every state expanded Medicaid under the Affordable Care Act (To date: Thirty one states and Washington, D.C. are on board). For example: South Dakota did not and North Dakota did. So we ought to have data about how much Medicaid money goes into the system, for what kind of patents, and how it’s used (hint: by law it’s supposed to remain at the local service unit.) We should have similar data for tribal or non-profit facilities. Life-saving data.
The Center for Budget and Policy Priorities released a report earlier this week that highlighted the connection between Medicaid and Indian Health. “The Medicaid expansion has improved access to care for thousands of American Indians and Alaska Natives especially in states with large AI/AN populations including Alaska, Arizona, and New Mexico. It has also provided much-needed revenue to Indian Health Service (IHS) and Tribally operated facilities, allowing them to expand services and hire and retain more staff. Ending Medicaid expansion would jeopardize coverage for these newly insured low-income AI/AN adults, and reduce revenue for IHS and Tribally operated facilities, forcing them to revert to pre-ACA service levels.”
In Montana, a state that recently expanded Medicaid, more than 11,000 American Indians have signed up for the insurance. “At a time when Montana is working in a bipartisan basis to address the suicide epidemic and improving health outcomes for American Indians, D.C. politicians are threatening to take away health insurance for thousands of Americans Indians in Montana,” said Heather Cahoon, State Tribal Policy Analyst for the Montana Budget and Policy Center. “More than 11,000 American Indians in Montana now have access to health insurance through our bi-partisan Medicaid expansion plan, and we can’t afford to go back.”
But going back is on the Senate agenda today. The Republican caucus is counting votes to see if a compromise is possible within their own ranks. The bill will be released, scored by the Congressional Budget Office, and, if Sen. Mitch McConnell gets his way, there will be a vote early next week.
But the facts are this: The Senate bill still strips $700 billion from Medicaid. And that number will grow over time. And the Trump administration is cutting from the already underfunded Indian Health Service budget by 6 percent. Now. That, too, will get worse down the road.
And so there will be many lies flying fast. It’s a health care bill. Or this legislation won’t take away your insurance. Medicaid will be better off. So will the patients. Whatever. The Congressional Budget Office is wrong. Then there’s that forever lie: That United States is meeting its solemn treaty promises to American Indians and Alaska Natives.
Reality TV works for one simple reason: The antics of the characters are beyond what’s believable in fiction. It’s compelling drama because normal people do not do such things. So part of watching is to find out when the story arc ends, to discover when the situation becomes “normal” again. (Even though the story does go on and on and on.)
That’s why the presidency of Donald J. Trump would make a terrible novel or screenplay: There’s no mechanism to suspend disbelief. Tell the story about a four-month term in the White House, a time marked by so much chaos, unprofessionalism, and distraction, and a reader (and especially an editor or producer) would shake their head and say, “Try again. This story is not believable.”
That’s why only the metaphor of reality TV works. America the unbelievable.
Last week the best moment of the new Trump Administration was the one where the president smiled in Saudi Arabia and said only 26 words. This was terrible reality TV but we all watched knowing that it was likely just a pause. Something outrageous must be coming up next.
The White House Reality Show is entertaining.
Meanwhile more important stories are still being written and played off-screen. That’s why our focus must return to the policy fights ahead: How this country (and our planet) deal with climate change, how we stop the rigging of elections, and, how we make certain the court system is fair. Next week the White House will formally send Congress its budget plan for the next year. We already know this plan will be nonsense. Another distraction. The real work of budgeting will occur in Congress and it will require votes from both Democrats and Republicans to make it so.
At a House hearing last week, for example, Rep. Tom Cole (R-Oklahoma) said he was disappointed in a White House recommendation to cut $5.8 billion from next year’s funding for the National Institutes of Health. He such a draconian cut would stall so much progress from recent investments.
In other words: No sale. Across the Congress, across the government, this same notion is being repeated. Eliminate the Corporation for Public Broadcast? No sale. Down the list the message is much the same, eliminate the Denali Commission? No sale. Etcetera, etcetera, etcetera.
Paying for health care
But while Congress might rewrite the budget in some areas, there are real dangers ahead. I’m obsessed with what this bunch is doing to the funding streams for health care, especially Medicaid.
This is what the Trump Show hides: The House’s American Health Care Act does much more than roll back the Affordable Care Act (or Obamacare as they like to say.) It ends a Medicaid program that works. It’s the single most effective form of “government” insurance that secures health care options for 62.3 million Americans. To add a little perspective here: Medicare — supposedly untouchable in politics — insures 43.3 million seniors.
These are huge numbers. Medicaid is expensive. And we all pay for this plan. As we should. It’s one of the best things this country does.
So it’s no wonder that Speaker Paul Ryan and Republicans are eager to make this go away (both because it costs so much and because it requires a lot of taxes to pay for this enterprise).
This is an issue where the philosophical divisions run deep. Every Republican wants to spend less federal money on this program. Significantly less. Once you do that, there will be fewer people who participate in this public insurance program. That’s math, not politics. The House plan (according to the Congressional Budget Office) strips $880 billion from Medicaid funding in order to reduce health care taxes on wealthy people by $883 billion. Tit for tat.
Watch this debate closely. Parse every word. The Republicans in the Senate who say they champion Medicaid often only talk about Medicaid expansion. And that’s followed by, there should be a transition to something else (namely, block grants that states cannot afford). What else? How does that work? And who pays?
At a town hall in Anchorage last week, Alaska Sen. Dan Sullivan followed this script to the letter. According to The Alaska Dispatch News the Republican senator told a contentious town hall, that he wanted to make sure the people who received health care coverage under Medicaid expansion “do not have the rug pulled out from under them.” Medicaid for now. Then something else. What else? How does that work? And who pays?
The answer is to protect the framework of Medicaid (and if we were smart, enhance and expand it). It’s the one part of Indian health funding that’s growing and already accounts for the insurance of record for more than half of all our children. (And, this is really important, third-party insurance billing, which includes Medicaid, is money that stays at a local IHS clinic or hospital. It does not go into the general budget.)
Medicaid is a partnership between the federal government and the states. So states set many of the rules, federal government then agrees or not, and pays only a portion of the bill. But patients within the Indian Health system are usually eligible for a 100 percent reimbursement.
So states set the rules for Indian Country — including limitations — yet don’t pay the cost. Already six states are already looking to tighten Medicaid rules. Arizona is keen on adding work requirements. Wisconsin wants drug testing (imagine the trap that sets for patients in opioid treatment programs). Maine wants to test assets beyond income. The goal of each new regulation is to shrink the number of people insured by Medicaid.
Medicaid works, especially in Indian Country
I’ve heard Republicans say they like the results of Medicaid but that we as a country cannot afford it. That’s particularly troubling because Medicaid is more efficient that private insurance. (Even with its convoluted payments from the federal government to states and Indian health programs). How can that be? Julia Paradise, associate director of the Program on Medicaid and the Uninsured for the Kaiser Family Foundation, says Medicaid acts as a “high risk pool.” Because so many people are excluded (or out-priced) from private insurance Medicaid is the only option. “Among adult Medicaid enrollees who are not working, illness or disability is the main reason. By covering many of the poorest and sickest Americans, Medicaid effectively serves as a high-risk pool for the private health insurance market, taking out the highest-cost people, thereby helping to keep private insurance premiums more affordable.”
The Senate is now busy rewriting the House’s awful health bill. It will be a different entity, that’s for sure. But will the Senate protect (and if they are smart, enhance and expand) the best basic public health insurance program that we have now? There is no evidence to suggest that. And too many people are watching reality TV to even notice.
Debra Haaland filed paperwork to run for Congress from New Mexico. If elected, she would be the first Native American woman to ever serve in that body. And what makes this news especially cool: This is a winnable seat.
Haaland, a member of Laguna Pueblo, has served the past two years as the state’s Democratic Party chair (where she successfully retired the party’s debts). She has also been a candidate for lieutenant governor and chaired the Laguna Development Corporation and has been a tribal administrator. Her Twitter profile says: “A proud UNM Lobo mom; Pueblo woman; Marathon runner; Gourmet cook.” She also tweeted: “Thank you for the outpouring of support! Stay tuned for more in the coming weeks … and is using the hashtag, #Deb4Congress and her web site is found at debforcongress.com.
“I’ve spent my life advocating for the underrepresented, advancing progressive values, and working tirelessly to help elect Democrats up and down the ballot,” Haaland said in a statement. “I want to ensure that everyone’s voice is heard, and it would be an honor to be that voice for our communities, our families, and for all of us.”
New Mexico’s First Congressional District includes Albuquerque and the north-central portion of the state. It’s currently represented by Michelle Lujan Grisham, a Democrat, who won with 65 percent of the vote and is now running for governor. The seat is rated “solid” or “safe” for the Democrats by several political reports.
Since this will be an “open” seat there will be a lot of competition. So the test for Haaland will be a primary election in June of next year. That means she will need early campaign money. Rep. Grisham raised $1.8 million for her re-election in 2016, however, the last time a Republican held this seat, former Rep. Heather Wilson, she raised and spent nearly $5 million.
As a former party chair, Haaland should be well-suited to take on the fundraising challenges. She has basically been raising money — albeit for others — for the past two years. She was the first Native American woman to serve as the party chair.
Former Montana State Sen. Carol Juneau once said that she considered state office because that’s where she could make a difference. (She is a member of the Mandan Hidatsa Arikara Tribe but was living in the Blackfeet Nation). The year was 1998. She was first appointed to the legislature to replace a man who left office to take up a seat on the Blackfeet Tribal Council and then she became one of two Native American members of the Montana House of Representatives. In February of 1999 she made the case to the House Democratic Caucus that Montana’s American Indians ought to have better representation, because tribal people “are citizens of the state of Montana, the same as any other citizens. I’d like to see that Indian people and Indian tribes in Montana aren’t left outside of everything.”
Today Native Montanans are not left out.
The state has the most Native Americans elected as legislators in the country, three members of the Senate and six members of the House. More than that: Montana has elected more women than any other state: Four of the nine legislators.
And though she is not currently in office, Denise Juneau (Carol’s daughter) was the only Native American woman to ever win a state constitutional office, she served two terms as the State Superintendent of Public Instruction, as well as a congressional candidate.
The Montana story has a national application, too. A higher percentage of Native American women serve in state legislatures than do women nationally.
Women make up about 25 percent of state legislatures. But a little more than 40 percent of all American Indian and Alaska Native legislators are female. The numbers break down this way: There are at least 67 Native American legislators out of 7,383 seats in 50 states or nearly one percent. (If you think that’s bad: Congress only has Native representation pegged at one-third of one percent.) Of those 67 seats, at least 25 of them are held by Native American women. So another way to look at the data: There are 1,800 legislative seats held by women; that works out to a Native representation of 1.4 percent.
There is still a long way to go to reach parity with the population, but it’s much better than just about any other category in the body politic. For example: A recent report by the Bureau of Indian Affairs shows more than 570 elected tribal leaders and, in that group, just under 25 percent are women.
The Native delegation in Minnesota is eighty percent female; its own caucus. (You could even argue that women are 100 percent of the delegation because the other tribal member in the legislature, Republican Rep. Steve Green, is White Earth Ojibwe, but he rarely champions or mentions tribal issues.)
A recent article in the Minnesota Post was headlined, “Something new for the Minnesota Legislature: A caucus of first Minnesotans.” Rep. Susan Allen, a member of the Rosebud Sioux Tribe, was first elected in a special election. “Before Allen was elected in 2012, only nine legislators in state history who self-identified as American Indian served in the Legislature — all men — and most of them were elected back when Minnesota was still considered a territory,” the Post said.
Allen told the Post: “You can be a part of an institution that is predominantly white and not have to lose your identity. I can be here without having to lose my identity to do it, and previous generations, I don’t think they had that.”
The Post explained several reasons why it’s so important for a legislature to hear from Native American legislators and for those elected representatives to keep an eye out for bills that impact the Native community.
One anecdote in particular was powerful. The Post said Rep. Mary Kunesh-Poden, a Standing Rock descendent, was giving American Indian students a tour of the Capitol. She could see they were overwhelmed. “I said, come back again and again and bring other Natives to the Capitol so that you’re not nervous, so that you’re not intimidated, so that some day you’ll be sitting in this office doing the work that we’re doing,” she said in the Post. “You could almost see the light bulb go off in their head: I could do this?”
Arizona is another state where most of the Native delegation — three out of four — are women. This fits Arizona. Its legislature is third in the nation for the highest percentage of women at nearly 40 percent.
New Mexico is the only state where the male-female balance is 50/50. And five states, Idaho, Kansas, Oregon, Utah and Wyoming, have only a woman representing Native Americans in the legislature. Conversely, Colorado, North Carolina, and North Dakota have only one Native American man serving in the legislature. Alaska (88 percent) and Oklahoma (86 percent) are primarily represented by men. South Dakota has three American Indian men in the legislature and no women.
Idaho’s Rep. Paulette Jordan, Couer d’Alene, is not only the only Native American in the legislature, she’s the only Democrat elected north of Boise. She told the Spokane Spokesman Review: “How can we continue to fight for balance in the state, with the overwhelming odds?That’s part of the beauty of our connection to our ancestors. We know that they’re always walking with us, guiding us and helping us in this lifetime … the fact that we’re still here – we still have the beauty, the inner identity, our connection to everything, to the land, to the earth itself, to our relatives both tribal and non-tribal alike.”
I don’t have the total numbers for Native Americans elected at the city and county level. Yet. (Early drafts of spreadsheets are here and here. Please do let me know who should be on these lists.)
But this much is clear: Debora Juarez, Blackfeet, currently represents more citizens than any Native woman in America (more than 90,000 people live in her North Seattle district). She was elected to Seattle’s City Council in November of 2015. In an interview with the Tacoma Art Museum she talked about her idea about the role of women: “While men were in charge of external power, women had interior, spiritual, and domestic power. They were the centers of the community.” That’s exactly how she’s approached her job on the council. She’s argued for community services from sidewalks to child car. On Juarez’ blog she reports: “In this budget I advocated for and secured $4.4 million in targeted investments in our community including improvements in human services, construction of sidewalks, and neighborhood planning initiatives. Ultimately, I achieved a 94% success rate for my specific District 5 budget priorities.”
Denise Juneau, of course, is the only Native American woman to hold statewide office (twice). She actually earned thousands of more votes from Montanans than did Barack Obama in 2012. (Previously: Denise Juneau’s eight years of promise.) She had a remarkable run even though last year fell short of being the first Native woman to ever win a seat in Congress.
In addition to Juneau, at least seven Native American women have run for Congress starting in 1988. Jeanne Givens, a Couer d’Alene tribal member in Idaho was the first. Then Ada Deer, Menominee, in Wisconsin, Kalyn Free, Choctaw, in Oklahoma, and Diane Benson, Tlingit, in Alaska, Three Native women have run in Arizona: Mary Kim Titla, White Mountain Apache, Arizona Rep. Wenona Benally, Navajo, and Victoria Steele, Seneca.
It’s so long past the time to erase that phrase, “ever” or for that matter, “the first” when it comes to Native women in office. And I suspect the 2018 elections will be a remarkable opportunity for more Native Americans to win office. It will be a referendum on President Donald J. Trump and his policies.
It’s also worth noting that Native American women have run for the vice presidency three times.
LaDonna Harris, Comanche, was on the ticket with Barry Commoner for the Citizen Party in 1980 (the year of Ronald Reagan’s landslide). This was Bernie Sanders before Bernie Sanders. The party highlighted the structural limits of the Democratic Party and blamed corporate America for the excess. The antidote was people power.
What’s interesting about the campaign now is that Commoner and Harris focused on environmental issues (long before the words global warming or climate change were in public discourse). Get this: The Citizens Party platform cited the role of science in managing complex environmental challenges.
“As a Comanche woman fighter, I’m proud to be a part of this party,” Harris said. “The traditions of my people have always held to the unity of the oppressed. That is why I want to show that we care about the problems of Chicanos, the Blacks, women, the elderly and the poor.”
Winona LaDuke, White Earth Ojibwe, joined Ralph Nader on the Green Party Ticket in 2000 and again in 2004. When LaDuke announced her candidacy she was asked whether a Native woman from rural Minnesota should even be considered? “I would argue yes,” she said. “In fact, I would question the inverse. Can men of privilege … who do not feel the impact of policies on forests, children or their ability to breast-feed children … actually have the compassion to make policy that is reflective of the interests of others? At this point, I think not.”
A quick update. So a reader points out that I really ought to include Debora Juarez in this list (and in the broader review of Native women in office). And it’s a spot on suggestion.
So I have added Juarez and a couple of county commissioners I know about … but there should be more. Please let me know about women serving on city councils, as mayors, county commissions, etc. Montana? South Dakota? Alaska?
Do you know of any Native women who are elected as city and county officials that should be included? Thank you.
I am working on a piece about Native American women who were elected to office at the state (or, I wish, at the federal) level.
I have identified 62 American Indian or Alaska Natives in state legislatures — 25 women (40 percent) and 37 men (60 percent). As a comparison, nationally, women make up just under a quarter of all elected legislative seats. (1,363 members or 24.4 percent). And that means Native American women are 1.834 percent of the women who serve in office.
Also eight Native American women have run for Congress and two have run for the vice presidency.
I am planning a story and an interactive graphic for the weekend. (It’s taking me longer than I planned. I keep getting distracted by the frenetic pace of the Trump administration.
Not all the elected Native American Republicans make tribal issues any sort of priority. Minnesota Rep. Steve Green, for example, does not include tribal membership in his biography or in his campaign literature. Yet his district includes the White Earth Nation.
However most of the Native American Republicans who are elected to office also engage in Native policy issues before state legislatures, including support for enhancing tribal languages, teaching Native history, expanding or limiting tribal jurisdiction, voting rights, and, soon, state measures to shape the next version of health care reform.
One shared trait of the Native Americans who are elected as Republicans is support for fossil fuel energy development. “As a local elected official, I am outraged that Indian Country is prevented from harnessing our own energy resources by ever-increasing regulations,” New Mexico State Representative Sharon Clachischillage said in a Native Americans for Trump promotion. “The Trump Administration will ease restrictions on American energy reserves worth trillions of dollars. Together we will block the bureaucrats holding Native American businesses back and bring new jobs into our communities.”
But even the idea of energy development gets more complicated in Indian Country.As Sen. Hoffman reports on his biography page: “Every Alaskan deserves affordable energy. As a resource rich state (oil, gas, wind, and tidal), our state should and could, harness all of this energy to benefit all of its citizens. I pledge to continue to work towards reducing the high cost of energy in rural Alaska.” Anyone who’s purchased gas in a village — topping $6 a gallon in Hoffman’s home in Bethel — gets that.
But many of these same communities, especially in rural Alaska, are at the global warming frontline and more money will soon be required to build sea walls, fight more fires, or even relocate entire villages. In his biography, Hoffman only cites the opportunity. “Our backyard is changing opening new ventures, with the thawing of the tundra and the melting of the Arctic ice,” he writes. “It is my intent and my responsibility as your state Senator, to ensure our region participates …”
Then not every Republican even goes that far. Montana Sen. Jason Small, Northern Cheyenne, ran for office against Sharon Stewart-Peregoy, a Crow, to spur reinvestment in coal. Small recently wrote in The Billings Gazette: “Thirty million dollars a year in lost royalties, hundreds of direct jobs lost, thousands of families out of work and out of options, entire towns destroyed, statewide economic ripples, and over $1 trillion dollars in stranded assets, not necessarily because of market forces, but directly attributable to a political agenda. That is what we face in the current and unprecedented assault on reason and Montana’s economy in what has been dubbed ‘the War on Coal.’”
Then market forces will be a test of this notion. Can pro-coal Republicans legislate the revival of the coal industry? Small argued in the piece that “carbon capture and combined cycle technology can solve the global climate challenge posed in part by the world’s more than 7,000 coal-fired power plants.” Coal prices did surge after Trump’s election, at one point topping $110 per metric ton, but have since declined to about $83.50 per ton. Since the election at least one major power plant, the Navajo Generating Station near Page, has been marked for closure in two years. The Arizona utilities that own the generating station say that the low cost of natural gas is their primary reason for closing the plant. That in two words, market forces.
Waiting for Congress
Most state legislatures are waiting for Congress before taking action before another round of healthcare reform at the state level. And that’s a debate that is still hot. There are three distinct points of view about repealing and replacing the Affordable Care Act (or Obamacare). The plan by the House leadership (which has not been released yet) is supposed to be designed around tax credits instead of the insurance subsidies that are in the current law. Several of the most conservative members of the House and Senate see that as a new entitlement and have signaled their opposition. A third group of Republican moderates have been working with state governors to preserve Medicaid expansion because that insures some 22 million people (including more than $800 million for the Indian health system).
Rep. Cole is a likely supporter of the plan that emerges from House leadership. That includes a repeal of the Affordable Care Act as well as the Medicaid expansion. He recently told Native America Calling that Oklahoma did not choose to expand Medicaid and that made the system unequal.
However Cole said what ever plan emerges he said the Indian Health Care Improvement Act is a “bedrock” legal authority that must remain. “This legislation was included … purely as ‘vote bait’ to secure Democratic votes and has nothing to do with” the Affordable Care Act,” Cole said. “It is vital and ensures that Native Americans have quality health care available to them and their families. There is no controversy here – it sets the national policy for many programs and services provided by the Indian Health Service.”
A few weeks ago the repeal of the Affordable Care Act seemed like a sure thing. And now? The next week or two could answer that question. And the course that’s picked will have a huge impact on the Indian health system.
And, over that same time frame, Native American Republicans will be asked to take a stand about deep budget cuts across federal agencies. Several news agencies have reported that the Office of Management and Budget is calling for a $1.3 billion cut at the Interior Department. Interior Secretary Ryan Zinke employees that he did look at the budget and is not happy about it, according to Energy & Environment News. “We’re going to fight about it,” Zinke said, “and I think I’m going to win at the end of the day.” E & E News reported that Zinke would engage in a major reorganization of the department, one that focuses the agency on the next one hundred years (including the promotion of tribal sovereignty).
It’s easy to find the issues where Native American Democrats and Republicans disagree. Indeed it would be simple for me to shape every column as doom and gloom, the logic of “Oh, what is that Trump going to do next?” But that won’t help the policy debates that are so important to Indian Country. But that idea discounts how much agreement there is out there — even in this hyper-partisan climate. It was Rep. Cole who helped champion the reauthorization of the Violence Against Women Act in 2013, including the provisions for tribal jurisdiction over non-Indians. Tribes still have a lot of work to do to implement that law. Deborah Parker, former vice chair of the Tulalip Tribes, and a key supporter of the act, said tribes should get their law and order codes ready now to comply with the law. Too few tribes have taken that step and VAWA will again require reauthorization in 2018 so Indian Country has to present its strongest case for this Congress.
One example of a Native American issue that cuts across party lines is unfolding in Wyoming. The Indian Education for All, House Bill 76, would require the state’s schools to educate all children about the history and economic contributions by the Eastern Shoshone and Northern Arapaho Tribes.
Sen. Affie Ellis was just elected in November and is a co-sponsor of the legislation. She’s a Navajo who grew up in Wyoming and she told the Casper Star-Tribune that Native American students sometimes are threatened by verbal abuse during sports trips across the state. “It’s a really important first step to understanding each other a little bit better,” she told The Star-Tribune. “It’s a brief idea, and I think it’s a fitting one.”
At the recent Conservative Political Action Conference, or CPAC, Ellis spoke at a panel titled, “Rising Stars in the Conservative Movement.” Back in Wyoming her appearance generated both praise and criticism. The newspaper Planet Jackson Hole asked the question if Ellis was a “sane Republican alternative” to Trumpism? The paper quoted Ellis saying: “I think our country needs so desperately some thought and some well researched responses … There’s so many times when it’s easy to name call and have these cute hashtags that stick but we have to have strong facts and start communicating those facts in a very effective way. I think the hard part is the devil in the details of policy you’re working on doesn’t fit into small hashtags. Maybe we just need long hashtags.”
I don’t know about longer hashtags. The one I use, #NativePolicy, is short. But we certainly need more thoughtful, complex policy debates.
Last year I expected a record number of Native Americans to get elected to offices across the country. There were just so many really superb candidates running for Congress, state legislatures, and statewide offices. At one point my list topped a hundred candidates. Of course it didn’t turn out that way. Too many of those exceptional #NativeVote16 candidates lost. But my tally to date: Sixty-six elected representatives and senators. So the 2016 election cycle turned out to be more of a rebuilding year instead of one that broke records.
Yet it turns out there is still history to be made.
State legislatures are convening around the country this month and there is an interesting twist: Native Americans are in key leadership positions in at least seven states. That’s impressive — and critical right now because of the types of conversations that will be going back and forth between Washington, D.C., and state capitals about Medicaid, health care and energy policy.
Alaska is a great bipartisan example.
Two years ago former Sealaska chairman Byron Mallott, Tlingit, was elected the state’s Lt. Gov. (He was the Democratic Party’s nominee for governor, but joined an independent fusion ticket along with Gov. Bill Walker.) The Walker-Mallott administration elevated Native issues to an unprecedented level of influence. One of the governor’s first appointments was Valerie Nurr’araaluk Davidson, an Orutsararmiut Native Council tribal member, and a long time health advocate, as the state’s commissioner for the the state’s Department of Health and Social Services. She will be the one negotiating with the Trump administration about what Medicaid will look like if Congress acts to repeal the Affordable Care Act.
Then the state legislature and the Walker-Mallott administration have been at odds over state spending and resources. Alaska has a multibillion dollar budget deficit largely because of the state’s reliance on taxes from oil and gas. As The Fairbanks Daily Miner put it: “Fortunately for the state, previous years when oil revenues were high allowed legislators to sock away billions of dollars in savings accounts. Unfortunately for the state, it was easier for legislators to spend from these savings accounts than make the hard decisions that would put Alaska on a path to a balanced budget.” Further complicating that budget challenge, Alaska citizens are paid a per capita distribution instead of paying income or other general taxes.
So after this election a new alliance was formed in the legislature to try and come up solutions, three Republicans and two independents joined the Democrats to form a majority caucus. The Speaker of the House in this coalition is Bryce Edgmon, Yup’ik. He said his native background is how he views the world. He told the Bristol Bay Times: “I know it’s not only my children and maybe their children’s future, but it’s also the future of our way of life out here in rural Alaska and a lot of our Native villages.”
There are now eight Alaska Natives in the legislature representing both parties. Rep. Sam Kito III, Tlingit, is chair of the Labor & Commerce Committee as well as the Legislative Council (a joint committee with the Senate). Neal Foster is co-chair of the Finance Committee.And Dean Westlake, Inupiaq, is chair of the Economic Development Committee and Arctic Policy. In the Senate, Lyman Hoffman, a Democrat who caucuses with Republicans, is co-chair of the Senate Finance Committee. The House Minority Leader is Charisse Millett, Inupiaq. In a previous legislature, Millett was instrumental in legislating Alaska Native languages as official state languages.
Actually I wrote “bipartisan.” That’s probably the wrong word for what’s occurring in Alaska because a few elected representatives run for election identifying with one party, only to caucus with the other after the election. (Perhaps a model for Congress?)
Oklahoma and Montana are the two states with the most Native legislators, nine. A larger group of Native legislators makes it easier to form a caucus so members can work together on issues important in Native communities. And both states have an active Native caucus.
Oklahoma legislators are leaders in both parties. In the House, Rep. Mark McBride, Potawatomi, is the Assistant Majority Floor Leader. Rep. Chuck Hoskin, Cherokee, is the Minority Whip. And in the Senate, Anastasia Pittman, Seminole, is the Assistant Democratic Leader.
Montana’s newly elected Rep. Shane Morigeau, Confederated Salish and Kootenai Tribes, will serve in leadership this session as Minority Whip. It’s a rare honor for a freshman.
Montana’s American Indian caucus was an important voice in the last legislature on issues ranging from tribal college funding to water compacts. “We’ve been literally and figuratively the minority’s minority,” Rep. Susan Webber, Blackfeet, told the Billings Gazette. “I know it looks like we have a lot of people in the Indian caucus, a lot of people were elected, but in reality it should be more. But just us getting in there, from my perspective, is a real positive.”
A critical challenge for the American Indian Caucus this session will be Medicaid. Montana came late to Medicaid expansion under the Affordable Care Act but its impact has been swift. The state’s uninsured rate dropped from 20 percent in 2012 to 7.4 percent last year. A report by The Montana Budget and Policy Center says a repeal of the Affordable Care Act “could have disastrous impacts on Montana, putting at risk the health care coverage of over 142,000 Montanans who have benefited from ACA measures. At the greatest risk are the over 61,000 Montanans who gained access to affordable health care coverage through Montana’s Medicaid expansion plan.” Worse: the report found that “repeal could cause a greater number of uninsured Montanans than before the ACA was enacted.”
Montana Budget and Policy says 8,000 American Indians are enrolled in insurance through the Medicaid expansion program. Third-party insurance, such as Medicaid, has added nearly a billion dollars to the Indian Health Service budget. “Nationwide, reimbursements at IHS facilities, tribal operated facilities, and urban Indian clinics have increased 21% since the expansion of Medicaid,” the report said. “In 2014, nearly 40% of American Indians did not have health insurance, but Medicaid expansion represented one of the most significant opportunities to expand coverage for American Indians.”
This is important because if Congress repeals the Affordable Care Act, it will be up to state governments to pick up the pieces (as well as the cost) or strip millions of Americans from health insurance coverage. Repeal without new resources could devastate the Indian health system.
Other states where Native American legislators are included in the leadership structure: Hawaii, where Andria Tupola is Minority Floor Leader; and in Colorado, Rep. Joseph Salazar is a committee vice chair.
In Washington Sen. John McCoy, Tulalip, has been a long-time champion of issues that are important in Native communities.
McCoy sponsored legislation to close coal burning power plants and “dramatically reduce the amount of coal burned to generate energy for Washington residents, reducing greenhouse gas emissions in Colstrip by 5 million tons — the equivalent of a million cars — a year.”
The senator says Washington Republicans and dental lobbyists are blocking the creation of a mid-level dental practice along the lines of what’s been done in several states. “Indian country may not have the loudest voice in Olympia, but it still has basic needs,” McCoy wrote in The Seattle Times.
“The idea is pretty simple — allow native communities to train and recruit dental therapists to help clear the backlog of an ongoing oral-health crisis. The research is alarming — one-quarter of Native Americans aged 35 to 44 years have fewer than 20 of their natural teeth,” he wrote. “The dentists also ignore the groundbreaking success of similar programs in other states. It’s been working for 11 years for indigenous communities in Alaska, where 45,000 people are seeing reliable providers for the first time in their lives.”
This issue is not going to go away. A new national survey reports that 45 percent of U.S. voters say they go without dental care because of cost or lack of insurance. But 8 of 10 favor adding midlevel providers as a solution. “Good oral health is critical to overall health, yet policies to expand access to dental care do not reflect this,” said Tera Bianchi, project director of the Dental Access Project at Community Catalyst. “Dental therapists offer better access to care for the most underserved populations in a cost-effective way to the system. They are a smart, effective bipartisan way to improve access to care.”
And this session McCoy will be the he face of the Democratic Party, chairing the caucus where he says he will help “foster the vision and values of Senate Democrats as they navigate the 2017 session.”
In other words: Sen. McCoy has a seat at the head of the table.
HELENA, Montana — It’s easy to think about politics as being about elections. We concentrate so much of our attention, our money, and our energy on campaigns. But then what? Most politicians run because they want to change things. They want government to be effective, to use the machinery of state for We, the People.
Pull back the lens and look at the past eight years and Denise Juneau’s term as Montana’s Superintendent of Public Instruction. Yes, it was a big deal for her to get elected. She is the first, and only, American Indian woman to hold a state constitutional office (such as governor or attorney general). She is a member of the Mandan Hidatsa and Arikara Nation and Blackfeet.
So then what?
“I have had a great time being Superintendent of Public Instruction. Eight years of working with communities across this state on Graduation Matters Montana, on Schools of Promise, on Farm to School, we could run down a whole litany of different topics,” Juneau said last week at the Montana Budget and Policy Center’s Legislative Summit. “There is really a lot to be proud of.”
In what Juneau said was her last public speech as Montana’s school superintendent she credited the work of Montana Budget and Policy Center and other community groups that worked together to bring about change. Take Graduation Matters Montana.
“When I first stepped into office, drop out rates were too high, way too many students were dropping out of school, and we used data, and we talked about information, we talked about reasons,” Juneau said. “The information you can then use to advocate for change. That change has actually resulted in 58 communities across this state pulling people together at a community level to get things done.”
The result: Raising Montana’s graduation rates to historic highs for two years in a row. And, at the same time, raising academic standards in English, math, science, arts, and health, so that that a high school diploma is more valuable.
Another successful effort was the Schools of Promise program in Montana’s tribal communities. That program, which began shortly after Juneau took office in 2009, were grants targeted to reservation communities and “struggling schools.” That program invested state resources, including an unprecedented 22 employees, so that the schools could get grants to improve everything from teaching to school leadership.
“I have learned from this position that being an advocate is so important, being able to use the position that you have, to talk to people about the important things that need to happen,” Juneau said. “I have just had a blast being the top advocate for public education for the last eight years and I could not be more proud of the work that happened.”
The superintendent’s term ends January 2.
Juneau also talked about her recent bid for Congress. She joins a remarkable group of Native American women who have run for that office, including: Jeanne Givens in Idaho, Diane Benson in Alaska, Ada Deer in Wisconsin, Kalyn Free in Oklahoma, and in Arizona, Wenona Benally, Mary Kim Titla and Victoria Steele. I reject the word, “unsuccessful.” It’s true that none of these candidates were elected. Yet. And every campaign, every challenge, only pushes the door open a bit wider. So: One day, soon.
“I am sad that I lost, but I do not feel bad about our campaign because we ran a damn good campaign,” Juneau said. “We raised more money than any Democrat that’s ever been in this race, we had good ads, we had great advocates out in the community, we had organizations helping us, we did everything we were supposed to do. We just lost. Those are bitter pills to swallow, but sometimes that’s what happens.” (Previous: Juneau for president?)
She said it doesn’t mean you get out of the game. “You stay in there and find other avenues to fight in and you make sure you are always, continually pushing what is in your heart and what is in your mind that you know is right,” she said. “Because if we don’t, nobody else will.”
And who knows what door will open next? “I am looking forward to doors opening, figuring out if I want to take advantage of that and bringing people with me,” Juneau said. “That’s what this game is about.”
If, then, this. A series of three words explaining what happens in any new White House. If Donald Trump wins the presidency, then many (not all) of the promises made during the campaign become policy. And it happens starting next month when the Congress races to try and make this so.
But “if, then, this,” is also about people. Who staffs the new campaign, especially those who represent Indian Country? And who represents the opposition?
As The Atlantic said about Price. He will be running a massive federal healthcare agency, one that “administers the largest health-research centers in the world, most of the country’s public-health apparatus, the Indian Health Service, the Food and Drug Administration, and a collection of welfare and child-care services. While Price has a less-established policy record on many of these issues, his general philosophy of rolling back government spending and intervention suggests he may scale back HHS’s current efforts.” A less established policy record opens up a lot of questions.
Another appointment, yet to be announced, would be in the next president’s executive office. Arizona State Sen. Carlyle Begay posted on Instagram: “It’s official … I’ll be working in the White House.” (Begay’s account is private, but it was reposted by Navajo Republicans on Facebook.) He doesn’t elaborate on the job title, but the most likely that post would be as a special assistant to the president on the Domestic Policy staff, a post now held by Karen Diver. Begay is Navajo.
One of the issues that the White House and Congress will have to flesh out is a proposal by Rep. Markwayne Mullin to reform the regulatory structure for tribal lands. A story in Reuters last week compared that plan to the termination, something that Mullin (who is a member of the Cherokee Nation) and former Interior Assistant Secretary Ross Swimmer say is not the case. Swimmer, who is also former principal chief for the Cherokee Nation, told Reuters: “It has to be done with an eye toward protecting sovereignty.”
Mullin said the press misunderstood him. He posted on Facebook: “This is a very personal and important issue for me and I want to clarify my actual comments that were distorted by the media. It is still and will always be my belief that the land entrusted to tribes belongs to the Native American people, and it ought to be up to them alone to decide how to best use and distribute the resources on their own land.”
Economist Terry Anderson has been making this case for years first from a think tank in Montana, The Property and Environment Research Center, and rom the Hoover Institution at Stanford University. He wrote just last month: “President-elect Trump is well positioned to grant more freedom to Native Americans.” (Note to Republicans: If you are serious about making this a policy, I would avoid the ‘free the Indians’ narrative. This was Arthur Watkins’ pitch during termination. The phrase has a definite and failed context.)
As will often be the case in a Trump White House, Anderson’s argument focuses on energy. “Considering the fact that tribes have an estimated $1.5 trillion in energy resources, President Trump should start by promoting more tribal authority over those resources,” Anderson wrote. “Such legislation is helping tribes like the coal-rich Crow. In 2013 it signed an option with Cloud Peak Energy, LLC to lease 1.4 billion tons of reservation coal. For the option, Cloud Peak paid the tribe $3.75 million and payments could increase to $10 million by 2018 if they start mining. These kinds of deals give Indians some reason for hope.”
If, then, this. Except. I would question at least one variable in this argument. If tribes have more say about resource extraction, then will tribes also have more say about environmental concerns? Does this logic give tribes a veto over resource extraction? Would that include approval or rejection of the Missouri River crossing of the Dakota Access Pipeline?
And specifically on coal, if there is a smaller global market for coal, then what’s the point? The International Energy Agency last year reduced its prediction for coal demand (after a decade of growing sales) in part because China’s consumption is dropping sharply. “The coal industry is facing huge pressures, and the main reason is China, but it is not the only reason,” said the agency’s executive director Fatih Birol. “The economic transformation in China and environmental policies worldwide – including the recent climate agreement in Paris – will likely continue to constrain global coal demand.”
That study predicts coal from India and Australia are growing and that the pipeline is already exceeding the capacity. “Probable” new export mining capacities amount to approximately 95 million tonnes per annum. But the current market environment strongly discourages investments as a substantial rebound of coal prices before 2020 is unlikely. Consequently, further postponements or cancellations of projects are expected.” So it’s not a great time to unleash coal as a market force (unless even lower prices are the goal).
If the world is moving past fossil fuel expansion, then the markets will not be there. This will not change in a pro-coal administration.
If there is to be a Secretary McMorris Rodgers, then who would develop and implement policy for Indian Country as the Assistant Secretary for Indian Affairs? There are a lot of talented Republicans who will be making their case in the next few days and weeks. You would hope that people who have served in previous administrations, such as Swimmer, will have a say in what qualities should be sought to match the requirements of the office. Same goes for elected leaders such as Mullin, Rep. Tom Cole, and even those in state governments, such as New Mexico Rep. Sharon Clahchischilliage, a member of the Navajo Nation.
The idea of “if, then, this,” is also important to the opposition party, the Democrats.
McMorris Rodgers must give up her congressional seat. And already there are three candidates. But former Colville Chairman Joe Pakootas said he will not run in a special election. He’s now chief executive of Spokane Tribal Enterprises.
But there are other ballot possibilities. Minnesota Rep. Keith Ellison is a candidate to chair the Democratic National Committee. If he were to win that job, then he has said he would give up his seat in Congress. Already on Twitter there is speculation that the best candidate for the House seat would be Minnesota Rep. Peggy Flanagan, White Earth Band of Ojibwe.