Latest attack on Medicaid also sabotages Treaty Rights, Indian health programs

Agency Says Indian Health Should Not Be Exempt From Medicaid Work Rules Because They Are ‘Race-Based’

Mark Trahant / Trahant Reports

The Trump administration is supporting a major policy shift on Indian health programs which could result in a loss of millions of dollars and sabotage treaty rights.

A story in Politico Sunday raised the issue. It said “the Trump administration contends the tribes are a race rather than separate governments, and exempting them from Medicaid work rules — which have been approved in three states and are being sought by at least 10 others — would be illegal preferential treatment. ‘HHS believes that such an exemption would raise constitutional and federal civil rights law concerns,’ according to a review by administration lawyers,” Politico said.

The new policy on Medicaid work requirements “does not honor the duty of the federal government to uphold the government-to-government relationship and recognize the political status enshrined in the Constitution, treaties, federal statutes, and other federal laws, said Jacqueline Pata, executive director of the National Congress of American Indians. “Our political relationship is not based upon race.”

“The United States has a legal responsibility to provide health care to Native Americans,” Mary Smith, who was acting head of the Indian Health Service during the Obama administration and is a member of the Cherokee Nation, told Politico. “It’s the largest prepaid health system in the world — they’ve paid through land and massacres — and now you’re going to take away health care and add a work requirement?”

Medicaid has become a key funding stream for the Indian health system — especially in programs managed by tribes and non-profits. Medicaid is a state-federal partnership and public insurance. The Affordable Care Act expanded Medicaid eligibility, but the Supreme Court ruled that each state could decide whether or not to expand. Since the expansion of Medicaid some 237,000 American Indians and Alaska Natives in 19 states have become insured.

Officially Medicaid represents 13 percent of the Indian Health Service’s $6.1 billion budget (just under $800 million).

But even that number is misleading because it does not include money collected from third-party billing from tribal and non-profit organizations. In Alaska, for example, the entire Alaska Native health system is operated by tribes or tribal organizations and the state says 40 percent of its $1.8 billion Medicaid budget is spent on Alaska Native patients. That one state approaches the entire “budgeted” amount for Medicaid.

Other states report similar increases. Kaiser Family Foundation found that in Arizona, one tribally-operated health system reported that about half of visits were by patients covered by Medicaid in 2016. And, an Urban Indian Health Program, reported that its uninsured rate at one clinic fell from 85 percent before the Affordable Care Act to under 10 percent.

Those Medicaid (and all insurance) dollars are even more significant because by law they remain with local service units where the patient is treated (and the insurance is billed). In Alaska more than two-thirds of those dollars are spent on private sector doctors and hospitals through purchased care for Alaska Native patients. And, unlike IHS funds, Medicaid is an entitlement. So if a person is eligible, the money follows.

A recent report by Kaiser Health News looked at Census data and found that 52 percent of residents in New Mexico’s McKinley County have coverage through the Medicaid.  That’s the highest rate among U.S. counties with at least 65,000 people. “The heavy concentration of Medicaid in this high-altitude desert is a result of two factors: the high poverty rate and the Indian Health Service’s relentless work to enroll patients in the program,” Kaiser reported. Most of McKinley County is located on the Navajo and Zuni reservations.


Kaiser Health News said Medicaid has opened up new opportunities for Native patients to “get more timely care, especially surgery and mental health services. It has been vital in combating high rates of obesity, teen birth, suicide and diabetes, according to local health officials.”

However the growth of Medicaid is resulting in unequal care for patients in the Indian health system. The benefits in some states, including those that expanded Medicaid under the Affordable Care Act, are more generous. Other states not only refused to expand Medicaid and have been adding new restrictions such as requiring “able-bodied” adults to have their Medicaid eligibility contingent on work.

But the Indian health system — the federal Indian Health Service and tribally and nonprofit operated programs — are in a special case because there is a 100 percent federal match for most services. So states set the rules, but do not have to pay the bill. (Medicaid is often the second largest single item in a state budget behind public schools.)

Medicaid is the largest health insurance program in America, insuring one in five adults, and many with complex and long-term chronic care needs. The Trump administration and many state legislatures controlled by Republicans see Medicaid as a welfare program. While most Democrats view it simply as a public health insurance program.

Work rules are particularly challenging for Indian Country. Unlike other Medicaid programs, patients in the Indian health system will still be eligible to receive basic care. So stricter rules will mean fewer people will sign up for Medicaid and the Indian Health Service — already significantly underfunded — will have to pick up the extra costs from existing appropriations. That will result in less money, and fewer healthcare services, across the board.

A letter from the Tribal Technical Advisory Group for Medicare and Medicaid said American Indians and Alaska Natives “are among the nation’s most vulnerable populations, and rely heavily on the IHS for health care. However, the IHS is currently funded at around 60 percent of need, and average per capita spending for IHS patients is only $3,688.” The latest per person cost for health care nationally is $10,348 (totalling $3.3 trillion, nearly 20 percent of the entire economy).

The tribal advisory group said it is “critically important” that there be a blanket exemption for IHS beneficiaries from the mandatory work requirements.

A report in September by the Kaiser Family Foundation showed that the majority of American Indians and Alaska Natives on Medicaid already work, yet continue to face high rates of poverty. It said over three-quarters of American Indians and Alaska Natives are in working families, but that’s a gap of about 8 percent compared to other Americans (83 percent).

The Trump administration’s characterization of tribal health programs as “race-based” is particularly troubling to tribal leaders because it would reverse historical precedence.

A memo last month from the law firm of Hobbs, Straus, Dean & Walker said the Centers for Medicare and Medicaid Services “has ample legal authority to single out IHS beneficiaries for special treatment in administering the statutes under its jurisdiction if doing so is rationally related to its unique trust responsibility to Indians. Under familiar principles of Indian law, such actions are political in nature, and as a result do not constitute prohibited race based classifications. This principle has been recognized and repeatedly reaffirmed by the Supreme Court and every Circuit Court of Appeals that has considered it, and has been extended to the actions of Administrative Agencies like the Department of Health and Human Services even in the absence of a specific statute.”

Mark Trahant is editor of Indian Country Today. He is a Shoshone-Bannock tribal citzen. On Twitter: @TrahantReports Cross posted on Indian Country Today.

(The National Congress of American Indians is the owner of Indian Country Today and manages its business operations. The Indian Country Today editorial team operates independently as a digital journalism enterprise.)

 

Tax cuts? Hell. No. Thousands of American Indian and Alaska Native children will lose health insurance

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Mark Trahant / Trahant Reports

Congress has yet to reenact the Children’s Health Insurance Program and states will soon run out of funds to prop up the program. That will mean that thousands of American Indian and Alaska Native children will lose their health insurance. And, the result is the Indian Health Service will have to stretch its already thin dollars to try and cover the budget hole.

The Children’s Health Insurance Program expired Sept. 30. This federal program insures young people and pregnant women who make just enough money not to qualify for Medicaid (but can’t afford private insurance). The idea is to make sure that every child has the resources to see a doctor when they are ill.

It’s hard to break down precise numbers because agencies lump funds from the Children’s Health Insurance Program or CHIP into Medicaid data. But we do know that the law worked really well. We also know there are more than 216,000 children that have health insurance because of Medicaid and the CHIP. Indeed, Native American children rely on Medicaid and CHIP at much higher percentages than other population groups. A study by Georgetown reported that 54 percent of American Indian and Alaska Native children were enrolled in Medicaid or CHIP as compared to 39 percent of all children. “Even though much progress has been made in extending Medicaid coverage to American Indians and Alaska Natives, the uninsured rate for American Indian and Alaska Native children and families remain unacceptably high,” the report said.

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Source: Georgetown University Health Policy Institute. Coverage Trends for American Indian and Alaska Native Children and Families.

Overall the uninsured rate among non-elderly American Indians and Alaska Natives fell by 7 percentage points from 24 percent to 17 percent, according to the Kaiser Family Foundation.

This is a big deal and here’s why: The Indian Health Service is a health care delivery operation that works best when insurance (third-party billing in government-speak) pays for the medical costs. Medicaid, CHIP, Medicare, and other third-party billing now accounts for 22 percent of the IHS’ $6.15 billion budget.

But if Children’s health is no longer funded (because Congress did not reauthorize the legislation) then the Indian Health Service will have to make up the difference. That means taking money away from other patients and programs. It will be a critical problem for clinics because by law dollars from third-party billing (or Medicaid and CHIP) remain local.

Alaska is the state most impacted by Congress’ failure to act because two-thirds of the children in the Native health system are covered by Medicaid or CHIP. Other states where there will be significant hits: Montana, North Dakota, South Dakota, Washington, New Mexico, Oklahoma, North Carolina, and California.

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Source: Georgetown University Health Policy Institute

The House of Representatives passed a CHIP reauthorization in early November. But that bill included a $6.35 billion budget cut to other health programs, including the Prevention and Public Health Fund, which provides money for vaccines, smoking cessation, and other initiatives to improve public health. The House would also ban lottery winners from being insured by Medicaid, tighten the timetable for people to sign up, and to change other rules.

It’s unlikely the Senate will agree. But the Senate is not moving quickly to pass its own legislation. The Senate is too busy working out tax cuts that will benefit large corporations and the very wealthy. (Previous post: What matters? Tax fight is about seven competing values.)

Across the country, some nine million low- and middle-income children rely on CHIP for health coverage. And, according to The Hill newspaper, States have asked the Centers for Medicare and Medicaid Services for funding to hold them over in the interim, and the agency has awarded about $607 million in redistributed funds to states and U.S. territories. Tribes will also lose hundreds of thousands of dollars in CHIP-related grants.

Last month, Utah Republican Orrin Hatch, who chairs the Senate committee responsible, called CHIP a “top priority” that had bipartisan support. The committee passed the bill October 2. But it’s up to Majority Leader Mitch McConnell, R-Kentucky, to bring the legislation to the floor for enactment. Then the House and Senate would have to iron out and agree on their differences before the bill can become law.

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

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Seriously? States complain to Senate about the burden of Native health care #IndigenousNewsWire

 

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Medicaid has worked under the Affordable Care Act, reducing the number of uninsured in Indian Country. (Kaiser Family Foundation)

Mark Trahant / Trahant Reports

First: A fantasy. Wouldn’t it be cool if once, just once, there was a debate in Congress that could only be decided by a vote that benefits Native people? I don’t know. Something like, “I won’t vote for any bill unless it fulfills the treaty obligations that the United States has promised Native people.” It could happen, right?

Well the current Senate debate on health care has a twist on this pipe dream. States are complaining about the burden, that’s right, the burden of Native American health care. So here’s the deal now: When an eligible Native American gets services through the Indian Health system, the cost is a 100 percent federal obligation. But, if that person or family is on Medicaid they could also get care from any provider. In that case the state would have to pay its share of the cost as it does for any other citizen. 

As the Kaiser Family Foundation points out: “Just as with other eligible individuals, AIANs who meet state eligibility standards are entitled to Medicaid coverage in the state in which they reside. AIANs may qualify for Medicaid regardless of whether they are a member of a federally-recognized Tribe, whether they live on or off a reservation, and whether they receive services (or are eligible to receive services) at an IHS- or Tribally-operated hospital or clinic. AIANs with Medicaid can access care through all providers who accept Medicaid for all Medicaid covered benefits. As such, they have access to a broader array of services and providers than those who rely solely on IHS services for care. Moreover, Medicaid has special eligibility rules and provides specific consumer protections to AIANs.”

The Graham-Cassidy plan would change that by making this cost a 100 percent federal obligation. States would be off the hook.

This is where it gets screwy. There are legitimate state concerns — basically it’s a complicated maze to figure out a patient’s path and how the money flows. But it’s still a benefit for states because Native people are citizens and so a full-federal match for most costs is a net gain.

South Dakota (a state that did not expand Medicaid) would gain $795 million from a block grant, but would still lose a significant share of its health care funding between 2020 and 2026, according to the Kaiser Family Foundation.

But (and I can’t believe I am writing this sentence) Sen. Mike Rounds told South Dakota Public Radio that the state would get a “large chunk of funds would cover 100 percent of the healthcare costs for Native Americans who receive Medicaid. Right now, the Affordable Care Act requires a state match.”

This is a fraction of what the state will lose — so this is a straight-faced claim that Native health care is a burden. (Remember this cost is only for tribal citizens who do not use Indian Health Service, a small slice of the population.)

South Dakota is not alone. A state legislative report in Arizona estimated that the state will lose a third of its Medicaid funding ($3.8 billion now, $4.9 billion by 2020). But according to the Capitol Media Services of the Arizona Daily Star, Gov. Doug Ducey dismisses those losses because the numbers are not from an independent review. Yet there is not enough time for the Senate to get a Congressional Budget Office assessment by the September 30 deadline. So this is all being made up on the fly.

“Christina Corieri, the governor’s health policy advisor, said one of those provisions would free the state of its financial obligations to share the cost when Native Americans get care at non-Indian Health Service facilities,” the Arizona Daily Star said. Corieri “could not say what that number would save Arizona other than ‘it’s a very large number.'”

Seriously?

There are roughly 130,000 Native Americans in Arizona on Medicaid, about 6 percent of the state’s version of Medicaid, the Arizona Health Care Cost Containment System. And of that, we’re talking about a subset, those who choose to go outside of the Indian health system. It’s just not a very large number. Period.

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

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

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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!”

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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

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Lies we’re told: Strip millions (billions) from health care & call it better

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At a Senate appropriations subcommittee hearing Wednesday there was a testy exchange between Sen. Jon Tester, D-Montana, and the acting director of the Indian Health Service Rear Admiral Michael Weahkee (Zuni). Tester asked how money can be taken from the budget without hurting the quality of care or staffing at IHS. The Senate video is here.

Mark Trahant / Trahant Reports

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.”

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I have been writing a lot about the GOP plans in the House and Senate. Three recent pieces: 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.) And I still find I have something to say because the Senate and House bills are so harmful to Indian Country.

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.

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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.

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“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.

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

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She Represents. A survey of Native American women who’ve been elected

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Click for interactive version of this graphic.

Mark Trahant / Trahant Reports

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.

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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.”

Nearly all of the Native American women who serve in state legislatures are Democrats. 21 out of 25. But it’s also worth mentioning that two of those Republican women are in leadership in Alaska and Hawaii. (Previously: Native Republicans open up a channel for discourse about Indian Country’s issues.)

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.)

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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. (City of Seattle photo)

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.”

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

 

Challenges to Dakota Access Pipeline are shifting into new shapes, new fronts

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President Donald J. Trump says the Dakota Access Pipeline is not even controversial. Yet the challenges to that project are taking new form. (Photo via YouTube)

 

Could there be a day, one day, without oil?

Mark Trahant / Trahant Reports

The Trump administration has been in office for less than a month — and already the construction of the Dakota Access Pipeline is again proceeding. Company officials say oil will be flowing by June.

Yes, there is a flurry of activity around the Dakota Access Pipeline, a project that has cost more than $3.8 billion to transfer oil from North Dakota to markets in Illinois and beyond.

But every action to build the pipeline is met with many more reactions to stop it. The fight about this pipeline — and the broader issues it represents — is far from over.

Of course some days it does not seem that way. The U.S. Army Corps of Engineers approved the final easement for the pipeline to cross under the Missouri River and complete the project. The Corps also withdrew its ongoing environmental review, citing President Donald J. Trump’s executive memorandum. But that begs a huge question for the courts: Can a president do that? Is an order from the president (along with previous environmental findings from the Corps) enough to satisfy the law? That question will be sorted out by the courts.

But there are many other challenges to the pipeline.

A press release from the Standing Rock Sioux Tribe said if the construction is successful “the tribe will seek to shut the pipeline operations down.” The tribe has also called for a march next month in the nation’s capital.

“Our fight is no longer at the North Dakota site itself,” said tribal chairman Dave Archambault II. “Our fight is with Congress and the Trump administration. Meet us in Washington on March 10.”

In addition there remain water protectors near the construction site itself (as well as a massive cleanup of where people were camping in flood-prone areas).

What’s clear about the “what’s next?” is that the battle against the Dakota Access Pipeline is taking a very different form. And it’s also a new start because there will be many more actions as the administration and oil-related companies move to restart the Keystone XL pipeline, or in Canada, the Kinder Morgan pipeline.

Then President Trump lives in a world where none of this is a big deal. “I don’t even think it was controversial,” he said. “I haven’t had one call.”

Then the White House wasn’t taking calls. So the Center for Investigative Reporting and its Reveal News has created a new phone number to solicit voice mails from the public about what they would tell the president. It’s 510-545-2640. This is your opportunity to sound off.

Another challenge is financial. Many individuals, tribes, cities, and companies are pulling their money from the banks who finance the Dakota Access Pipeline. But that’s really just the beginning of the actions ahead. Rebecca Adamson, founder of First Peoples Worldwide, points out to investors how much capital is lost by companies that operate without consent from the community involved. A cost she has pegged at somewhere between $20 million to $30 million a week when there are operational disruptions. “The time it takes to bring oil and gas projects on-line has doubled over the course of the past decade due to community opposition, creating significant financial loss,” Adamson writes. More investors are learning about that financial risk and even more need to understand  what’s at stake.

“The movement to stop the Dakota Access Pipeline (DAPL) is wreaking financial havoc on the companies and banks involved,” Adamson writes. “In August 2016, Energy Transfer Partners reported ‘it could lose $1.4 billion in a year if delays continue … Even a temporary delay would mean loses of over $430 million.’ ETP is attempting to raise new debt. This could mean that the banks are ramping up pressure on the company to repay their loans out of concern DAPL will never be finished. In November 2016, Energy Transfer Partners announced a merger with sister company Sunoco Logistics in order to raise much needed cash to finish construction. Energy Transfer Partners’ own shareholders are filing a lawsuit to block the merger, alleging conflicts of interest.”

Like I said: The financial challenges are just beginning.

I also have a big idea I want to toss out. One that could have significant financial implications. So we know the project will take some 30 days to complete. And about three weeks to actually transfer oil from North Dakota to the end of the pipeline. (Updated: Company officials told the U.S. District Court that oil could begin flowing in less than four weeks.)

What if on that day, the day the oil reaches markets, there is a Day Without Oil. One day. It take a massive organizational effort. But why not? What if every ally of Standing Rock, every community that has its own Standing Rock, every one who is concerned about water, takes a day off from oil? Either walk every where that day — or just stay home. Do what it takes to remind the companies, and the government itself, who’s really in charge of the economy.

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

 

Journalism Fail: Standing Rock arrest puts the First Amendment on trial

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Native American media have been quick to jump to the defense of journalist Jenni Monet. She was arrested near Standing Rock last week. But most of the press has been silent about the charges she faces (and the implications for the First Amendment). Photo: Aboriginal People’s Television Network.

Jenni Monet faces criminal trespass and rioting charges

Mark Trahant / Trahant Reports

Jenni Monet, a Native American journalist, was arrested last week while covering Standing Rock. You’d think that would trigger a lot of support from the national and regional news media. 

There is an idea in law enforcement called the “thin blue line.” It basically means that police work together. A call goes out from Morton County and, right or wrong, law enforcement from around the country provides back up.

You would think journalism would be like that too.

When one journalist is threatened, we all are. We cannot do our jobs when we worry about being injured or worse. And when a journalist is arrested? Well, everyone who claims the First Amendment as a framework should object loudly.

Last Wednesday Monet was arrested near Cannonball, North Dakota. She was interviewing water protectors who were setting up a new camp near the Dakota Access Pipeline route on treaty lands of the Great Sioux Nation. Law enforcement from Morton County surrounded the camp and captured everyone within the circle. A press release from the sheriff’s Department puts it this way: “Approximately 76 members of a rogue group of protestors were arrested.”  Most were charged with criminal trespassing and inciting a riot.

As was Monet. She now faces serious charges and the judicial process will go forward. The truth must come out.

But this story is about the failure of journalism institutions.

The Native press and the institutions that carry her work had Monet’s back. That includes Indian Country Media Network, Yes! Magazine, and the Center for Investigative Reporting’s Reveal. In Canada the Aboriginal People’s Television Network reported on the story during its evening news. And, The Los Angeles Times has now weighed as well in with its own story written by Sandy Tolan who’s done some great reporting from Standing Rock. The Native American Journalists Association released a statement immediately: “Yesterday’s unlawful arrest of Native journalist Jenni Monet by Morton County officers is patently illegal and a blatant betrayal of our closely held American values of free speech and a free press,” NAJA President Bryan Pollard said, “Jenni is an accomplished journalist and consummate professional who was covering a story on behalf of Indian Country Today. Unfortunately, this arrest is not unprecedented, and Morton County officials must review their officer training and department policies to ensure that officers are able and empowered to distinguish between protesters and journalists who are in pursuit of truthful reporting.”

Yet in North Dakota you would not know this arrest happened. The press is silent. (UPDATE on Feb. 7: Bismarck Tribune reports on the arrest.)

I have heard from many, many individual journalists. That’s fantastic. But what about the institutions of journalism? There should news stories in print, digital and broadcast. There should be editorials calling out North Dakota for this egregious act. If the institutions let this moment pass, every journalist covering a protest across the country will be at risk of arrest.

After her release from jail, Monet wrote for Indian Country Media Network, “When Democracy Now!’s Amy Goodman was charged with the same allegations I now face—criminal trespassing and rioting—her message to the world embraced the First Amendment. ‘There’s a reason why journalism is explicitly protected by the U.S. Constitution,’ she said before a crowd gathered in front of the Morton County courthouse. “Because we’re supposed to be the check and balance on power.”

The funny thing is that journalism institutions were not quick to embrace Goodman either. I have talked to many journalists who see her as an “other” because she practices a different kind of journalism than they do.

Monet’s brand of journalism is rooted in facts and good reporting. She talks to everyone on all sides of the story, including the Morton County Sheriff and North Dakota’s new governor. She also has street cred … and knows how to tell a story. Just listen to her podcast — Still Here — and you will know that to be true.

So if we ever need journalism institutions to rally, it’s now. It’s not Jenni Monet who will be on trial. It’s the First Amendment. Journalism is not a crime. 

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 president’s logic on the Dakota Access Pipeline: Because I said so.

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Announcement of order by Acting Army Secretary was posted on the web site of North Dakota Sen. John Hoeven on Jan. 31. (Screenshot of Senator’s home page.)

Tribe says Corps does not have authority to stop environmental review

 

**Updated Feb. 8, 2017

Mark Trahant / Trahant Reports

Cognitive scientist George Lakoff once described the process for Republican thinking. It’s a set of assumptions built on the idea of a strict father.

He wrote in his classic book, Don’t Think of an Elephant, “The strict father model begins with a set of assumptions: The world is a dangerous place, and always will be, because there is evil out there in the world. The world is also difficult because it is competitive. There will always be winners and losers. There is an absolute right and an absolute wrong. Children are born bad, in the sense that they just want to do what feels good, not what is right. Therefore they have to be made good.”

Donald J. Trump is the strict father who runs his family — and in this case, the United States — on the model that all he needs to say to defend any action is “because I said so.” The president’s executive memorandum on Standing Rock is exhibit one.

“Today, the Acting Secretary of the Army Robert Speer informed us that he has directed the Army Corps of Engineers to proceed with the easement needed to complete the Dakota Access Pipeline,” North Dakota Sen. John Hoeven said in a news release. “This will enable the company to complete the project, which can and will be built with the necessary safety features to protect the Standing Rock Sioux Tribe and others downstream. Building new energy infrastructure with the latest safeguards and technology is the safest and most environmentally sound way to move energy from where it is produced to where people need it.”

Just like that. The Corps is supposed to walk away from a process already underway, the Environmental Impact Statement and the public comment period that is open until Feb. 20, 2017. (The Army has since announced that it is withdrawing its environmental review and approving the easement immediately.)

This is now a test of the federal courts. Will that institution follow the order of the acting secretary, and the president, or will it insist on the conclusion of the environmental review that’s underway.

First: It’s interesting that th announcement came from a U.S. Senator and not the agency itself.

The Federal Register, the rule book for government, published a plan for the review process on Jan. 18. Yes, there is a new administration, but that does not (or should not) change the rules. The notice, unlike the president’s memorandum, cites the statutory authority for moving forward. This is more than you want to read … but here goes: “This notice is published in accordance with sections 1503.1 and 1506.6 of the CEQ’s Regulations (40 CFR parts 1500-1508) implementing the procedural requirements of NEPA, as amended (42 U.S.C. 4321 et seq.), and the Army and Corps’ NEPA implementation policies (32 CFR part 651 and 33 CFR part 230), and exercises the authority delegated to the Assistant Secretary of the Army (Civil Works) by General Orders No. 2017-1, January 5, 2017.”

Of course this action will also open a new round of litigation. That will be the test of the independence of the federal judiciary. Will federal judges tell the president no? Will litigation even be allowed (strange as those words sound)? The Trump administration and North Dakota certainly hopes not. That process takes too long in a world run by oil gadzillionaires.

A statement by the Standing Rock Sioux Tribe Tuesday said: “The Army Corps lacks statutory authority to simply stop the EIS and issue the easement. The Corps must review the Presidential Memorandum, notify Congress, and actually grant the easement.We have not received formal notice that the EIS has been suspended or withdrawn. To abandon the EIS would amount to a wholly unexplained and arbitrary change based on the President’s personal views and, potentially, personal investments. We stand ready to fight this battle against corporate interest superseding government procedure and the health and well being of millions of Americans.”

Sen. Hoeven said “we need to bring (this dispute) to a peaceful resolution.” Yet the president’s action, the order by the acting secretary of the Army Corps of Engineers, and the very idea of a strict father shouting, because I said so,” is not how to make a peaceful resolution.

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

 

Five ways Indian Country can challenge the policies of the Trump White House

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Official government portrait of President Donald J. Trump even telling us what to think about the president’s success story. Would that be the riches to riches narrative?  (WhiteHouse.gov photo)

 

America First? How about First American First?

Mark Trahant / Trahant Reports

How does Indian Country survive the Donald Trump era?

The new administration is only a few days old and already the chaos of the times have upset business as usual. And possibly the very structure of federal-Indian law.

And it’s not just Washington. The North Dakota Legislature in Bismarck acts as if it has permission to ignore the Constitution and precedent in its relationship with tribes. House Concurrent Resolution 3017 calls on Congress to “modify” the reservation system and put the state in charge.

This resolution will last about fifteen minutes if and when legislators put a pencil to what it would actually cost taxpayers. Right now, for example, the federal government picks up the entire tab for Medicaid for American Indian tribal members. Plus add to that the operation of the Indian Health Service. We’re already talking millions of dollars and that’s only one program, health. What’s really driving this is that North Dakota legislators are angry about Standing Rock and greedy for more oil and gas money from the Mandan Hidatsa Arikara Nation. So North Dakota is ready to assume government expenses for Indian Country across the state? Silly, rabbits.

But Indian Country is now a target and so many Trump supporters are emboldened by an administration that does not know how to say no to those who would trample on constitutional rights. This will be true for many who run federal agencies, state governments, oil, gas, and coal producers, and the Congress. In their mind: Indian Country has had it too good for too long. Imagine that.

So what’s Indian Country’s response to the nonsense? Consider these five ideas.

First. Don’t count out the bureaucracy. I first started covering federal Indian policy during the late 1970s. I was in DC and was interviewing someone about a reform project at the Bureau of Indian Affairs, a plan that I thought made a lot of sense. But my source smiled and responded, “I have seen them come. I have seen them go.” There are many ways to tie up initiatives — even good ones — through the process of government. President Donald J. Trump’s memoranda might fit into this category. Usually an executive order or a memorandum has a legal framework as part of the document, including citing the statutory authority for the presidential action. On Dakota Access and Keystone that reference has been replaced by the logic of “because I said so.” We shall see.

Second. Ronald Reagan famously said government is not the solution, but the problem. This era might flip that idea around because the federal government’s inaction on such issues as global warming will make it less relevant. The rest of the world, even conservative allies of the Trump White House, are moving ahead on climate action. To pretend that oil, gas, and coal are the future is only a fantasy. There may be a temporary uptick in fossil fuels, but that cannot last. This is an opportunity for tribes to look for new allies outside of the federal government, even globally. The America First policy signals uncertainty in global governance so perhaps the counter should be, First Americans First.

Tribes should work closer with cities, states, private companies, and any global government that’s open to help. The federal government is going to be close to useless for the next four years (unless the Trump infrastructure program happens, and includes Indian Country, but there is no evidence of that yet.) The modern city state, think a Seattle, Portland, Minneapolis or a Phoenix, as the real engines of growth in this country. What’s the best way for tribes to become partners?

Third. Young people aren’t playing by the old rules, either. If the president wants change he should look at what young people are already doing — and that direction is very different than his.

Take driving. The data shows that both Millennials and Gen-Xers have less interest in driving (and fossil fuel consumption) than any generation in modern history. A recent report published by Time found a “huge drop of 47 percentage points in 16-year-olds with drivers’ licenses. For people ages 20 to 24, there’s been a 16 percentage point decrease over the same time span. And for those ages 30 to 34, the decrease has been about 10 percentage points.” Young people say they are too busy. Driving is too expensive. And It’s easy to catch a ride.

The Millennials are now the largest generation in America so that disinterest in driving — and fossil fuel consumption — is a powerful trend. Of course this is not always the same in rural areas, including reservations. But it’s key to fossil fuel consumption. Make that less fossil fuel consumption. And a shrinking demand for pipelines.

Indian Country’s greatest advantage right now is young people, more than 40 percent of our total population (compared to about a third for country as a whole.) We have numbers working in our favor and should look for more ways to leverage that.

Fourth. Don’t count out Republican versus Republican. Right now Republicans in Congress are giving President Trump the benefit of the doubt. They are willing to reverse long held positions (such as free trade) because he’s the leader of their party and he claims to lead a movement. But as the decisions get harder, the act of governing gets more complex, this will evaporate.

There is already evidence of this in the debate about repealing the Affordable Care Act. The idea of getting rid of Obamacare was a unifying force. But there is no consensus about what’s next. Republican governors fear that their state budgets will collapse if Medicaid becomes a block grant with less funding. Insurance CEOs fear their future if the mandate to buy insurance goes away while they are still forced to cover pre-existing conditions. And many Republicans in Congress cling to the idea that health care should be left up to families and government should not be involved or fund it. And Republicans who want to win the election know that stripping heath insurance from millions of people is not a winning hand.

Fifth. Document everything and be transparent. The Trump era is already defined by the wacky claim of alternative facts. The antidote is to respond with hard evidence. We know that zealots are eager to reshape the federal government by shrinking it. So let’s document with that really means. What jobs are lost (and how will those be replaced?) I’ve started a spreadsheet and will update it regularly.  This president has promised a new era of jobs. So lost work in Indian Country is not acceptable.

There are many ways for tribes to survive the Trump era. My main point is that we need to think differently. Usually a new presidential term starts with a president trying to bridge gaps and bring the country together. That’s not been the case from President Trump and so we should expect more of the same in the years ahead. It’s more important than ever to have a strategy, a plan for winning. What will it take? Who are potential allies? And what are alternatives that might work?

And, of course, we must start getting ready for the next election.

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