[Congressional Record (Bound Edition), Volume 155 (2009), Part 16]
[Extensions of Remarks]
[Pages 22169-22170]
[From the U.S. Government Publishing Office, www.gpo.gov]




      INTRODUCING TRIBAL HEALTH BENEFITS CLARIFICATION ACT OF 2009

                                 ______
                                 

                          HON. XAVIER BECERRA

                             of california

                    in the house of representatives

                       Monday, September 21, 2009

  Mr. BECERRA. Madam Speaker, I rise to introduce the ``Tribal Health 
Benefits Clarification Act of 2009'' with Representatives Devin Nunes, 
Nick Rahall, Joe Baca, Shelley Berkley, Mary Bono Mack, Dan Boren, Tom 
Cole, Wally Herger, Dale Kildee, John Kline, Jerry Lewis, Ben Ray 
Lujan, Kevin McCarthy, Betty McCollum, Frank Pallone, Earl Pomeroy, 
George Radanovich, and Heath Shuler. This bipartisan legislation will 
clarify that medical care and health coverage provided by Indian tribes 
for their members, as well as health care provided by the Indian Health 
Service, or IHS, are not taxable under the Internal Revenue Code.
  The federal government has a longstanding policy of providing medical 
care to Indians. To effect this policy, 25 U.S.C. section 1601 states a 
``major national goal of the United States is to provide the quantity 
and quality of health services which will permit the health status of 
Indians to be raised to the highest possible level,'' and specific 
authorization for IHS is provided in 25 U.S.C. section 13.
  However, statistics on the health status of Native Americans compared 
with the general population are alarming. Native Americans have a life 
expectancy that is nearly 5 years shorter than other Americans, and 
death rates from diseases such as tuberculosis, alcoholism, and 
diabetes that are many times higher than in the general population.
  Despite this overwhelming need, funds appropriated for IHS programs 
have been consistently inadequate to meet even basic health care 
requirements. In fact, IHS has found that per beneficiary, the IHS 
received 40 percent less funding than the average cost of a mainstream 
health insurance plan, thus limiting health care services and 
contributing to poorer health outcomes among the population it is 
intended to serve.
  To address the needs of their people in the face of the IHS funding 
shortfall, many Indian tribal governments have dedicated portions of 
their revenues to funding health care programs. The IRS and federal 
courts have consistently held that payments made under similar social 
benefit programs for the promotion

[[Page 22170]]

of general welfare are not taxable. However, the test to determine 
whether a benefit falls under this doctrine is based on facts and 
circumstances and is difficult to apply. In addition, no formal 
guidance has been issued by the IRS to assist in these determinations. 
Statutory language is needed to clarify the tax treatment of these 
medical care benefits.
  The ``Tribal Health Benefits Clarification Act of 2009'' would 
provide a statutory clarification that, consistent with the federal 
government's policy of providing health care services to Indians, 
neither health care provided by IHS nor medical care provided by an 
Indian tribe to its members is subject to income taxation.
  I urge my colleagues to join us in supporting this important 
bipartisan legislation to further the federal government's stated goal 
of raising the health status of the Native American community.

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