[Congressional Record (Bound Edition), Volume 154 (2008), Part 1]
[Senate]
[Page 470]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   INDIAN HEALTH CARE IMPROVEMENT ACT

  Mr. BAUCUS. Madam President, I rise to speak briefly on the next 
order of business, and that is the Indian Health Care Improvement Act.
  In the 1939 WPA Guide to Montana, it is written:

       The Indian attitude toward the land was expressed by a Crow 
     named Curly.

  He was from the Crow Indian tribe. Here is what he said:

       The soil you see is not ordinary soil--it is the dust of 
     the blood, the flesh, and the bones of our ancestors. You 
     will have to dig down to find Nature's earth, for the upper 
     portion is Crow, my blood and my dead. I do not want to give 
     it up.

  But over our long national history, we all know, sadly, the Federal 
Government repeatedly separated America's original inhabitants from the 
land they so dearly loved and continue to love. As a result of that sad 
and sometimes dishonorable history, as a result of treaties, statutes, 
court decisions, executive orders, and moral obligations, the United 
States owes a singular debt to its Native Americans.
  In partial fulfillment of that obligation, in 1976, Congress passed 
the first Indian Health Care Improvement Act. That 1976 law was the 
first legislative statement of goals for Federal Indian health care 
programs. That law established the first statutory requirements for the 
provision of resources to meet those goals.
  In that 1976 act, the Congress found that:

       Federal health services to maintain and improve the health 
     of the Indians are consonant with and required by the Federal 
     Government's historical and unique legal relationship with, 
     and resulting responsibility to, the American Indian people.

  Today, when we get to the bill--I think roughly in about an hour from 
now--at long last, we will have before us the Indian Health Care 
Improvement Act of 2007. It has been a long trail that has led us here 
today. It is important we made the journey to get here. This bill will 
provide better health care for nearly 2 million American Indians from 
562 federally recognized American Indian and Alaska Native tribes. We 
need to improve the health care of Native Americans. Native Americans 
suffer from tuberculosis at a rate 7\1/2\ times higher than the non-
Indian population. The Native American suicide rate is 60 percent 
higher than in the general population.
  Medicare--our program for seniors--spends about $6,800 per person a 
year. Medicaid--the low-income program for health care--spends about 
$4,300 per person. The Bureau of Prisons spends about $3,200 per person 
for health care. But the Indian Health Service spends only $2,100 for 
health care. That is less than a third of Medicare, less than half of 
Medicaid, and a third less than what the Federal Government spends for 
medical care for prisoners.
  From the beginning of the Indian Health Care Improvement Act of 1976, 
Medicare and Medicaid have played a part in paying for health care 
delivered to Native Americans. The 1976 act amended the Social Security 
Act ``to permit reimbursement by Medicare and Medicaid for covered 
services provided by the Indian Health Service.'' Today, Medicare, 
Medicaid, and now the Children's Health Insurance Program are a 
significant source of funding for health care delivered to Native 
Americans.
  I am proud that an important part of the Indian Health Care 
Improvement Act before us today is a product of the Finance Committee. 
That committee's provisions address health care provided to Indians 
through Medicare, Medicaid, and the Children's Health Insurance 
Program. Those provisions would increase outreach and enrollment of 
Indians in Medicaid and the Children's Health Insurance Program. These 
provisions would protect Indian health care providers from 
discrimination in payment for services and require States and the 
Secretary of HHS to consult with Indian health providers, and they 
would ensure that Medicaid managed care organizations pay Indian health 
providers appropriately.
  It is a good package. It is not near enough. It is an abomination--it 
is a tragedy what little attention we pay to Native Americans' health 
care needs. I wish more people in the country would visit Indian 
reservations. I wish they would visit Indian Health Service hospitals. 
They would realize the abysmal plight of so many people in America. But 
this bill helps. It helps provide more resources where people need it--
not near enough but more--and I strongly encourage the Senate to pass 
this bill when we get to it in the next hour or so. Congress should 
reauthorize the Indian Health Care Improvement Act.
  The United States owes a debt to the Native American population whose 
ancestors are tied up with the very soil all Americans share. The 
Federal Government owes a duty to help improve the health of American 
Indians. And we in this Senate have the obligation to pass this act and 
honor the flesh, the bones, and the blood of our Indian brethren.
  Madam President, I yield the floor and suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DORGAN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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