This week I am teaching map making in my reporting class. As I was thinking through how to do that, I was thinking, “I ought to build a map.” What kind of map? Well, it would be cool to show where every American Indian or Alaska Native is running for office. At the federal level, Senate and House, at the state level, legislatures, and important offices, such as city councils or state superintendent of public instruction.
I’ll do this both in map form and build a graphic table.
Omnibus is a Latin word that means “for all.” In legislation it means cramming everything into a bill that you think can pass. That’s exactly what the House did with its two-year $80 billion spending bill. That bill lifts caps from the Budget Control Act, or the sequester, and it raises the debt limit until March 2017. The Senate passed the measure early Friday morning. This bill awaits President Obama’s signature to become law.
The best part of this bill is that ends distractions such as defunding Planned Parenthood until after the election. The worst part of this deal is that the spending details still have to be written. As Molly E. Reynolds of Brookings puts it: “What it does not do, however, is push actual government dollars out the door to pay for discretionary federal programs—including major health, education, and science initiatives—after December 11, when the temporary funding measure passed at the end of September expires. Under the terms of the deal, members of the House and Senate appropriations committees will have until that December deadline to choose exactly how to spend according with the broader framework.”
The politics of this deal (and another House action) are stunning, but, unfortunately, probably only temporary. More Democrats voted for the bill than Republicans. So the Leadership picked a bipartisan course. That happened again with individual members who used a parliamentary measure to bring the Export-Import Bank up for a vote.
The Senate still has to weigh in on the Export-Import Bank and there is no indication when that debate will occur or if the votes are there to pass it. Folks who want to shrink government want this international financing program to go away, calling it corporate welfare. Supporters say that the competition is from other countries and failure to re-establish the bank will put U.S. interests at a disadvantage.
Of course any budget that passes with more Democrats than Republicans is considered awful. The new Speaker of the House Paul Ryan said the process stinks. But the bill will make it easier for Ryan to govern his caucus because it takes away the threat of government shutdowns and general chaos. Ryan’s goal will be to unite the Republicans so what ever measures come forward next will be debated within the party caucus and then sent to the floor with more unity. So Democratic votes will not be needed. At least that’s the theory. We will see if it works.
Critics of the spending bill (including those Republican candidates in Wednesday’s debate) say this shows how government spending is out of control. The problem with that argument is the numbers. The deficit is shrinking. What’s missing from the discourse is that the United States has a long-term spending problem. Not a budget crisis. The Congressional Budget Office says, “This year’s deficit will be noticeably smaller than what the agency projected in March, and fiscal year 2015 will mark the sixth consecutive year in which the deficit has declined as a percentage of gross domestic product (GDP) since it peaked in 2009. Over the next 10 years, however, the budget outlook remains much the same as CBO described earlier this year: If current laws generally remain unchanged, within a few years the deficit will begin to rise again relative to GDP, and by 2025, debt held by the public will be higher relative to the size of the economy than it is now.”
So the question remains can Congress, can the next president, can the public, think long term?
My goal for this blog is to make it a “for all” place for politics in Indian Country. To that end, I will be posting more press releases, op-eds, and other material from campaigns. I’d like to see a roundup of candidates across the country running in races large and small.
One important race that I have neglected to write about is from Seattle. Debora Juarez is a candidate for Seattle City Council. She’s a member of the Blackfeet Tribe, grew up in the Seattle-Tacoma area, and is running for a seat on neighborhood issues. That means things people care about: more sidewalks, better bus service, and affordable housing.
Juarez happens to be also extraordinary well qualified. This is what The Seattle Times said about her in its endorsement editorial: “In a crowded field, Debora Juarez stands out. She has lived in the district for 25 years while building an impressive résumé as a legal-aid lawyer, a King County judge, a Native American affairs adviser for two governors and a Wall Street investment adviser. She currently is counsel for Northwest tribes in a respected law firm and is a member of the Blackfeet tribe. She would bring intellectual rigor and ideological independence to the council.”
It doesn’t get any better than this.
Of course great candidates make all the difference in elections. They bring experience and poise to the campaign. That’s why so many eyes are watching Montana right now. The only Native American to hold a statewide office, Denise Juneau, is considering a run for the U.S. House. She’s currently Montana’s Superintendent of Public Instruction and a member of the Mandan and Hidatsa Tribes. She grew up in Browning on the Blackfeet Reservation.
Two years ago there was a lot of interest in Juneau running for an open U.S. Senate seat. I thought it would have been an interesting race, but it would have been a long shot. The problem is the type of voters Juneau would need only vote in presidential election years and that race would have been a low-turnout election. So she opted to stick with the job she loves, running public education.
But Juneau is now at her term limit. Her schools’ job will end. And since it’s a presidential year, the House seat is awfully tempting. It’s a seat that can be won. (It’s how Jon Tester won.) Stay tuned.
One Speaker of the House retires. Another says he’s in — until he’s out. And it’s hard to keep track of what all this means for Indian Country.
Let’s break it down.
As I have written before there are really three parties in Congress these days: Democrats, Republicans and a right-wing splinter group either called the Freedom Caucus or the Tea Party. On many issues the right wing votes and calls themselves Republicans. But not always. On some issues they think Republicans are wobbly and not conservative enough. Indeed, one of the reasons that Majority Leader Kevin McCarthy decided to not run for Speaker of the House was a list of impossible demands from this caucus. Their position is that the House should give more power to rank-and-file members and let the committee process debate policy (instead of leadership). But it’s also about making certain that the House doesn’t let the Senate or President Obama dictate the outcome of key fiscal and policy issues.
The magic number in Congress is 218 votes. That’s the number of votes it takes to pass legislation (or for that matter) to elect a new Speaker. (That’s means you need at least some votes from two of three factions in Congress.)
How does this impact Indian Country? There are a few ways for this story to play out.
The best alternative is that the current Speaker of the House John Boehner will end his career working for the good of the country, pushing through difficult legislation such as the budget and a lifting of the debt ceiling. He can do this with a coalition of a few Republicans and many more Democrats. This is what occurred with the bill that funds the government through December 11. Only 91 Republicans voted for the bill, but it passed easily after 186 Democrats voted yea. This could be a model for getting things done.
Ideally Boehner would reach a deal with the Senate and the president and come up with a two-year budget deal. That would keep federal funding stable through the election.
Another way legislation can move forward in a divided House is through a “discharge petition.” That’s when a majority of members, Republicans and Democrats, sign a petition that requires a bill to go directly to the House floor. This bypasses the Speaker and committees. Right now enough members have signed a discharge petition to restore funding to the Export-Import Bank and that bill will be considered later this month.
That’s the optimistic scenarios. But there is another possibility and that’s for more chaos. The Freedom Caucus could get its way and there would not be enough votes to pass a budget or raise the debt ceiling. Shutdown politics.
We already know how bad a government shutdown is for Indian Country. But the debt issue could also have dire consequences.
The United States is able to borrow money at extraordinary rates, under 3 percent. But if the right wing gets its way and allows the U.S. Treasury to default, even for a moment, those rates will go up. Think about it this way: The payment of the debt is one budget item that’s non-negotiable. If interest rates rise, and debt costs go up, that’s automatic spending, and that money will likely come out of existing programs.
Net interest payments are already huge. According to the Congressional Budget Office: “Interest payments on that debt represent a large and rapidly growing expense of the federal government … climbing from $231 billion in 2014, or 1.3 percent of GDP, to $799 billion in 2024, or 3.0 percent of GDP—the highest ratio since 1996.”
As I said, big numbers. The chaos in Congress is about real policy choices — and the direction that’s chosen will impact Indian Country for decades to come.
Once again Congress is finding it impossible to pass spending bills — and time is running out. The federal government appropriates money and runs its programs from October 1st through the end of September. The House and the Senate are supposed to enact appropriations and then pass on that legislation to the president for his signature.
That is how it is supposed to work.
But the entire process is chaotic. Think of Congress this way. There are really three-parties in the House and in the Senate; Republicans (the party in charge), Democrats and Tea Party supporters. It’s this third group who are holding up the budget by saying “no.” Congress could get out of this by letting Republicans work with Democrats on moderate spending bills — something that does happen in state Legislatures from time to time. And that might be the smartest route ahead. (It would likely mean the political career of Speaker John Boehner would be over. But it’s not a bad legacy to step out by doing the right thing.)
There are several issues dividing Congress ranging from the amount of debt the country has (think of a credit card limit) to how much money flows from government checks to Planned Parenthood.
But Planned Parenthood does many other things — such as distribution of birth control pills — and federal money already cannot be used for abortion. So it’s unlikely the president will agree to any budget that doesn’t continue funding women’s health programs and that includes Planned Parenthood. What’s more the whole controversy has been one-sided, there a case to be made that Planned Parenthood’s actions save lives. The issue is far more about abortion politics than it is about fetal tissue.
Back to the shutdown. Pretty much everyone in Washington says they do not want a government shutdown. But there is really no incentive to get beyond those words. Budget expert Stan Collender recently wrote in Politico magazine that there is a seventy-five percent chance of a shutdown. “First and foremost, there is not enough time to reach a deal. Not only have none of the fiscal 2016 appropriations yet been signed into law, none have even passed both the House and Senate. With less than two calendar weeks (and far fewer days of potential legislative work) to go, the only way to keep the government from shutting down will be for Congress and the president to agree on a continuing resolution to fund the government for a short time while a larger deal is negotiated,” he wrote. But then there is that Planned Parenthood debate — and staunch opposition to even a short-term spending bill.
Not only that but a temporary spending bill could cause additional problems. The Center for Budget and Policy Priorities says a Continuing Resolution would lock in spending cuts demanded by the sequestration law. “The only real fix is for policymakers to agree to provide relief from the sequestration cuts now scheduled for 2016, offsetting the cuts with alternate deficit reduction measures, as they did on a bipartisan basis in 2013, and then to enact regular appropriations legislation for 2016 (even if combined into one or more omnibus packages). As long as the current sequestration limits remain in place, no amount of re-arranging the pieces within an inadequate total will allow for necessary funding levels to reflect new priorities, new conditions, or rising costs,” the Center said.
We know that closing down government, even briefly, is rough.Two years ago the government closed from October 1 through October 16, 2013. Some 800,000 employees were furloughed and another 1.3 million had to work without pay.
Across Indian Country a government shutdown not only impacts federal employees, but it means tribes have less money and have to lay off employees as well. Two years ago, Indian Country Today Media Network reported that Montana’s Crow Tribe had to lay off some 300 people as well as closing essential reservation programs. Even some health clinics (which are supposed to be protected) had to close temporarily.
Native American organizations have been pushing for an idea to fund health, and perhaps tribal schools, a year in advance. That would be smart. Then when Congress cannot do its job, at least Indian Country won’t have to suffer needlessly. But Congress didn’t get around to that idea either.
One thing for sure: Government shutdowns cost a lot of money. The last tab was about $24 billion.
So here we go again with another waste of time and money.
What do you do with sixteen candidates? It’s a thorny problem for Republicans. Why’s that? Because right now one of those candidates, Donald Trump, is loud enough to drown out all the other “major” candidates.
Wouldn’t it be fun if the nomination contest was more like a basketball tournament? Then top-seeded Donald Trump would battle 16th seed Ohio Gov. John Kasich a battle of ideas. Or how about dropping the bunch in the jungle Naked and Afraid. We could even start voting and eliminate a candidate every week, until it’s just the Republican versus a Democrat.
Enough. Back to the chaos. And Donald Trump.
As The Washington Post put it on Sunday: “For yet another week, Trump talk dominated the Sunday morning political shows, with several devoting roundtable discussions to his disruption of the GOP presidential primary and at least two of his GOP rivals using their clashes with him in recent days as a means of securing interviews on the shows — during which they continued to clash with him.”
On August 6 in Cleveland the first debate is set, an opportunity to raise serious issues. As if. It’s more likely that it will be Trump versus the other nine candidates tossing one liners back and forth.
Of course American Indian and Alaska Native issues don’t get attention this early anyway. Usually that happens late in the campaigns, during the general election, when a position paper is released that outlines the candidate’s official policy. That’s too bad. It would be good to press candidates from both parties about how they see treaties, the federal-Indian relationship, and the management of federal programs that serve Native Americans.
Then again it’s pretty clear where most stand. The Tea Party wing of the Republicans — Trump, Marco Rubio, Scott Walker, Ben Carson, Ted Cruz, and Rand Paul — would dramatically cut federal spending. Paul has even called for the elimination of the Bureau of Indian Affairs and drastic cuts at the Indian Health Service. If any of this happened, the Sequester would be the Good Old Days.
Even a self-described serious candidate, former Florida Gov. Jeb Bush, suggests its time to reshape government. A few days ago in Tallahassee, he said that as governor he used a hiring freeze to shrink state government. He suggested the same approach would work in Washington where only one employee could be hired for every three who retire or leave government service. Bush also said it ought to be easier to fire federal employees. “There are a lot of exemplary employees in the federal government, but they’re treated no better than the bad ones,” he said. “The bad ones are almost impossible to effectively discipline or remove.”
Candidate Kasich was chairman of the House Budget Committee when President Bill Clinton declared the “era of big government is over.” That suited Kasich then. And now. One proposal at the time was to “reinvent” the Bureau of Indian Affairs with a block grant program. “The reinvented Bureau of Indian Affairs would provide block grants, rather than engaging in the direct provision of services or the direct supervision of tribal activities,” the House proposal said. This “would reduce the central office operations of the BIA by 50 percent and eliminate funding for the Navajo and western Oklahoma area offices. It would eliminate technical assistance of Indian enterprises, through which technical assistance for economic enterprises is provided by contracts with the private sector or with other Federal agencies.” Congress would have ended direct loans and reduce loan guarantees.
The Republicans running for president all share contempt for the Affordable Care Act (and most don’t know that would include the provisions of the Indian Health Care Improvement Act.) All are also supportive of more development, such as the Keystone XL pipeline, and generally dismissive of any action to limit climate change.
I don’t know. I’m still partial to a Naked and Afraid competition.
One more state adds “new money” to the Indian health system via Medicaid
These days “new” money is hard to find. That’s the kind of money that’s added to a budget, money that allows programs to expand, try out new ideas, and look for ways to make life better. Most government budgets are doing the opposite: Shrinking. Calling on program managers and clients alike to do more with less.
That’s why the news from Alaska last week is so exciting: Alaska’s new governor announced the expansion of Medicaid and this will significantly boost money for the Alaska Native medical system. Indeed, the significance of this announcement to the Indian health system was clear when Alaska’s Gov. Bill Walker and Department of Health and Social Services Commissioner Valerie Davidson made the announcement at the Alaska Native Medical Center on July 16. The governor took this action using executive authority because the Alaska legislature had failed to even vote on legislation to accept Medicaid.
The governor says Medicaid expansion would reduce state spending by $6.6 million in the first year, and save over $100 million in state general funds in the first six years. “Every day that we fail to act, Alaska loses out on $400,000,” the governor said. “With a nearly $3 billion budget deficit, it would be foolish for us to pass up that kind of boost to Alaska’s economy.”
“We know Gov. Walker has worked tirelessly to expand Medicaid since he came into office on December first,” Davidson said at the news conference. It was one of the campaign promises made by the independent governor. “He included it in the budget. He introduced a bill both in the House and in the Senate side. It was a subject of both special sessions. And, it’s the right thing do do for Alaska.”
The expansion of Medicaid is one of key components of the Affordable Care Act. It’s critical a tool for the Indian health system because it opens up a revenue channel for clinics and hospitals to bill Medicaid, a third-party insurance, for services and that boosts budgets at the local level. (In a climate where Congress is unlike to spend more money on Indian health.) How big a number? More than a million American Indians and Alaska Natives are now insured by Medicaid. The Kaiser Family Foundation estimated in 2013 that Indian health facilities collected $943 million in third-party payments.“By far the largest third-party payer is Medicaid, which accounts for $683 million or 70% of total third party revenues, and 13% of total IHS program funding for FY2013,” Kaiser reported. Nearly 150,000 Alaska Natives and American Indians receive health services across the state from tribal and non-profit health organizations funded by the Indian Health Service. By law the IHS-funded clinics must seek third party billing from patients, such as Medicaid, the Veterans Administration or private, employer-based health insurance.
Medicaid is an odd program for Indian Country. Most of us understand the Indian Health Service to be the government’s fulfillment of its treaty obligations. However the IHS has never been fully funded. Medicaid, however, is an unlimited check. If a person is eligible, then the money is there. Yet states, not tribes nor the federal government, determine the rules for Medicaid. And many Republican states have been determined to fight the Affordable Care Act, or Obamacare, at every turn, and that means refusing to accept Medicaid expansion (the Supreme Court ruled in 2012 that states could turn it down).
I like that: Missed opportunities. Why? Because this Council of Economic Advisers’ 44-page report fails to include any calculation of Indian Country as one of those missed opportunities.
I get that the population of American Indian and Alaska Natives is small, one percent or so. But you cannot build an economic case for Medicaid in Alaska, Oklahoma, Montana, North Dakota, South Dakota, Arizona, New Mexico (and even Washington and Oregon) without at least back of the envelope estimates. This is important because of the way Medicaid is structured; it’s a shared partnership between the states and the federal government. However American Indians and Alaska Natives are eligible for a 100 percent federal match, so the money spent by a state Medicaid program is fully reimbursed by the federal government.
This system, of course, makes no sense. And it’s probably why the White House failed or forgot to include Indian Country. A much sounder approach would be for the Indian health system — whether federal, tribal, urban or nonprofit — to get funding and administrative rules directly from the Centers for Medicare and Medicaid Services. Then Alaska, Oklahoma, or the other states that are currently rejecting Medicaid expansion would lose their say about what happens to American Indian and Alaska Native patients.
Let’s dig deeper into the White House report — then I’ll add numbers and context.
The administration is quite right to hail the Affordable Care Act’s economic success story. “Since the law’s major coverage provisions took effect at the start of 2014, the nation has seen the sharpest reduction in the uninsured rate since the decade following the creation of Medicare and Medicaid in 1965, and … the nation’s uninsured rate now stands at its lowest level ever.”
However 22 States—including many of the states that would benefit most—have not yet expanded Medicaid (although Montana has passed legislation to expand Medicaid and is working with the Centers for Medicare and Medicaid Services to determine the structure of its expansion). These 22 States have seen sharply slower progress in reducing the number of uninsured over the last year and a half, and researchers at the Urban Institute estimate that, if these States do not change course, 4.3 million of their citizens will be deprived of health insurance coverage in 2016.”
The White House report estimates Alaska would gain some $90 million in federal funds by expanding Medicaid. But that number, I believe, misses out the intersection between Medicaid and the Indian health system. The Alaska Native Tribal Health Consortium estimated that 41,500 Alaskans would be eligible for Medicaid — including 15,700 Alaska Natives and American Indians. In other words, more than a third of potential enrollees are eligible for a 100 percent federal reimbursement. Forever.
The numbers are similar and striking in South Dakota and Oklahoma.
The White House report says health insurance also reduces the risk of death. “This analysis estimates that if the 22 states that have not yet expanded Medicaid did so, 5,200 deaths would be avoided annually once expanded coverage was fully in effect. States that have already expanded Medicaid will avoid 5,000 deaths per year,” the report says.
This is a bit complicated, but I doubt if that number includes American Indians and Alaska Natives who are at risk of death because of funding shortages in the Indian health system. What’s now called Purchased and Referred Care is better funded than it has been in recent years, but that budget line still runs out of money for some patients needing specialty care outside of the Indian health system.
But the key point is that the Indian health system is underfunded and as the Kaiser Family Foundation noted “not equally distributed across facilities and they remain insufficient to meet health care needs.”
That unevenness is dangerous for the Indian health system — and it’s states that are limiting dollars by refusing to expand Medicaid.
We are seeing the evidence about how the Indian health system is picking up additional resources in states where there has been Medicaid expansion. In Washington, for example, I recently reported that tribal health facilities have increased their Medicaid funding by nearly 40 percent since expansion. This is new money in an era of austerity and it’s automatic funding that does not require appropriation from Congress.
Of course it would be ideal if the White House was making this case with hard numbers. The Indian health system is a federal obligation — a Treaty right — that costs states little. Yet it’s the states that are setting the rules; so at the very least our advocate ought to be chronicling that impact. It’s a missed opportunity.
Nevada will be the first state where Native voters weigh in
The first ballots for the 2016 presidential election will be cast in a little more than seven months. That means between now and January there will be a rush of candidates, a winnowing of those who fail to raise money or attention, and, if we are lucky, a philosophical and practical debate about the challenges facing the United States.
In an ideal world that discussion would include American Indian and Alaska Native concerns. But that never happens (unless you read between the lines).
So the Democrats — Former Secretary of State Hillary Clinton, Vermont Sen. Bernie Sanders, former Maryland Gov. Martin O’Malley, and the newest entrant, Rhode Island Gov. Lincoln Chafee (who once was a “liberal” Republican) — campaign on issues ranging from protecting and expanding voting rights to switching the U.S. to the metric system.
And the Republicans? Well, just listing the candidates is kind of like making sure you get all the names right when reporting about a school play. There are so many, you’re bound to miss someone. But here goes (in order of recent polling by Real Clear Politics): Former Florida Gov. Jeb Bush, Wisconsin Gov. Scott Walker, Florida Sen. Marco Rubio, Dr. Ben Carson, Kentucky Sen. Rand Paul, former Arkansas Gov. Mike Huckabee, Texas Sen. Ted Cruz, New Jersey Gov. Chris Christie, Donald Trump, former Texas Gov. Rick Perry, Ohio Gov. John Kasich, former Penn. Sen. Rick Santorum, Carly Fiorina, South Carolina Sen. Lindsay Graham, and Louisiana Gov. Bobby Jindal. And that’s only the 15 “major” candidates. So in order to make noise in that large a field some of those would-be presidents rode Harley’s across Iowa this weekend, revving up their engines and their rhetoric. Hardly the right atmosphere for a discussion about tribal sovereignty.
The early primary campaign season is not ideal for a serious discussion about Indian Country’s issues. The election calendar starts with Iowa, New Hampshire and South Carolina in late January.
Nevada will be the fourth state to vote — and the first state with a significant tribal population. There are more than thirty reservation communities, urban residents, and a total Native American population of about 1.6 percent. More important, Nevada remains a caucus state. So if a large number of Native Americans show up in the right locations, well, all bets are off. (Only 33,000 Republicans voted in the last Nevada caucus out of some 400,000 G.O.P. voters.)
And what if there was a Native candidate as a draw? This ought to be the year to make that so.
A Native American candidate could take advantage of a nasty, undemocratic (but legal) structure. The law allows secret donors to spend unlimited sums of money to benefit a single candidate. So what if a few of the wealthy tribes, and, yes, I do mean casino tribes, raised a lot of money for such a super PAC? (Even though the money cannot go directly to a candidate, it still has been used to boost candidates. In 2012, for example, former House Speaker Newt Gingrich was on the receiving end of more than $15 million from casino owner Sheldon Adelson and his wife.)
Coming up with a super PAC candidate from Indian Country is a tough sell for Democrats. Even though there are many folks who could (and should) be candidates, there are too few with a large enough political footprint. And taking that much money from a single source runs against what many grassroots type candidates believe anyway.
But on the Republican side, there is someone who has that credibility right now, Rep. Tom Cole of Oklahoma, a member of the Chickasaw Tribe.
Cole is as conservative as his Oklahoma voters yet he is often the voice of reason in the House of Representatives. He’s said that new revenue — meaning taxes — might be needed to get past the sequester and that repealing the Affordable Care Act might not be possible as long as a Democrat is in the White House. This alone distinguishes him from the other fifteen Republican candidates running for president.
He’s championed tribal sovereignty and was a key player in the House vote for the Violence Against Women Act. Let me be clear here: Cole fits the orthodoxy of the Republican Party. He supports pipeline construction and increasing oil and gas production. Cole also wants less federal spending and votes for budgets that would have negative impact on tribal communities. But for a Republican primary, and for a Republican candidate, Indian Country would still come out ahead, if he were running and raised the issues in Indian Country that call out for a larger debate.
The down side of a Cole candidacy is that he would have to give up his seat in the House — and his seniority and influence. That’s probably too high a cost for an improbable presidential quest. But this might be the year to try something outrageous.