Washington, D.C. – This week the Energy and Commerce Committee held a virtual hearing on how to best help tribal communities on a broad range of issues including health care, energy, and broadband infrastructure and access. Because E&C has jurisdiction in these areas, including the Indian Health Service (IHS), it’s important members were able to hold this hearing to help guide policy decisions that impact tribal communities.
These were the witnesses:
- Mr. Jonathan Nez, President, Navajo Nation
- The Honorable Christine Sage, Chairman, Southern Ute Indian Tribe
- Ms. Fawn R. Sharp, President, National Congress of American Indians
- Dr. Charles Grim D.D.S., M.H.S.A., Secretary, Department of Health, Chickasaw Nation
- Ms. Pilar M. Thomas, Partner, Quarles & Brady LLP
Here are some highlights from the hearing:
Rep. Markwayne Mullin (R-OK) talked about the importance of providing quality health care for Native Americans, as well as modernizing and adequately funding the IHS.
Mullin: Native Americans deserve quality and reliable health care services as promised by the federal government. In fact, it’s the only federal obligation for health care that we have out there. As a Cherokee, I grew up going to tribally-run hospitals at Hastings – which is just down the road from me in Tahlequah—where I received my health care, and I understand how important operating these direct services and facilities are to tribal members. Last Congress, I was fortunate enough to co-chair the IHS task force which led up to several key areas in which we can improve health care for over 2.2 million Native Americans. IHS is not only terribly underfunded, but it’s also the only federally funded health care agency that doesn’t receive mandatory or advance appropriations. We have to fix that. IHS must also be modernized. Its IT system needs to be brought into the 21st century. There’s so much going on in Indian country that applies to this committee, and we need to take a deeper dive.
Rep. Cathy McMorris Rodgers (R-WA), who represents several tribal communities in the 5th district of Washington, asked Dr. Grim about Medicaid, which Rodgers calls an “essential program.” Dr. Grim shared that Medicaid has helped improve health care but that expansion of this program should not be just the “see all and end all” solution to helping improve health care services for Native Americans.
Grim: Well as you pointed out, Congresswoman, those states that have it are doing better than those states that don’t. And some studies are coming out now that show it has improved the health care of the population but it’s not the see all and end all. And whenever, you know, you expand it that broadly, you start running into more problems. And, so there’s a group under CMS call the TTAG, the Tribal Technical Advisory Group. That group debates and discusses all of these issues with CMS. In my written testimony [I reference] a number of things that would both help the efficiency of the agency and tribes, but also the funding.
Chairman Christine Sage shared with Rep. Morgan Griffith (R-VA) how the National Environmental Policy Act, or NEPA, hinders development on tribal lands.
Sage: NEPA hinders reservation development and construction. Not just energy development, but every time a major federal action is pending, NEPA is triggered. At a minimum, agencies should use the tribal environment analysis. And for a tribe has a kind of sophisticated government, such as Southern Ute Indian Tribe, they should be allowed to develop and administer its own TEPA, Tribal Environmental Policy Act, instead of the federal NEPA.… the tribe often faces inconsistent requirements through the various federal agencies on a single project: BLM, BIA, and USFS (United States Forest Service) have inconsistent requirements. Consistency across federal partners would greatly benefit Indian country.
Chairman Christine Sage told Rep. Brett Guthrie (R-KY) about challenges the Southern Ute Indian Tribe has with broadband gaps, especially during COVID-19.
Sage: In dealing with the gap here with the internet service, we do have our own entity that I oversee, that is called a SUSS (Southern Ute Shared Services) department, and they monitor all of the internet, the WiFi that’s available for us. We are succeeding with this, but we do need the broadband. My concern with the broadband is that if our students are going to go to college, you know they’re going to have to be taking classes online. There’s no way they’re going to be able to do this because they don’t have the internet services they will need to succeed. And then our telehealth, we have IHS…They also say go through the states. It’s just always that we’re pushed aside.