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Washington, D.C. --- U.S. Rep. Frank Pallone, Jr. (D-NJ), Chairman of the House Energy and Commerce Subcommittee on Health, gave the following opening statement this morning at a subcommittee markup of H.R. 1328, the Indian Health Care Improvement Act.
"Good morning. Today the Subcommittee is meeting to mark up H.R. 1328, legislation I am proud to have introduced earlier this year to reauthorize and amend the Indian Health Care Improvement Act – the keystone federal law that directs the delivery of health care services to American Indian and Alaskan Native people.
"This day is long overdue and this legislation is desperately needed. According to a report commissioned in 1928 by the federal government on the health status of American Indians and Alaskan Natives:
'the health of Indians as compared with that of the general population is bad. The existing evidence warrants the statement that both the general death rates and the infant mortality rates are high. The prevailing living conditions among the great majority of the Indians are conducive to the development and spread of disease. With comparatively few exceptions, the diet of the Indians is bad. The housing conditions are likewise conducive to bad health. The inadequacy of appropriations has prevented the development of an adequate system of public health system and medical relief work for the Indians.'
"Sadly, much of the substance of that report remains true today. American Indians and Alaskan Natives still suffer disproportionately from poor health outcomes and a lack of access to adequate health care services. Native Americans are dying of diabetes, alcoholism, tuberculosis, suicide, and other chronic conditions and diseases at alarming rates.
"A large part of the problem is that American Indians have greater difficulty in accessing quality health care. For far too many years, there has been a growing divide between the health care services afforded Native American communities and other segments of the population.
"In example after example, Native Americans do not receive a level of service comparable to other Americans. Even the simplest of services, which many of us take for granted are extremely hard to come by for American Indians and Alaskan Natives, most of whom live in isolated, sparsely populated and underserved areas of our country. As a result, many Native Americans must overcome significant barriers in order to simply access services such as primary medical care, dental and vision services.
"In 1976, the Indian Health Care Improvement Act was first enacted to address many of these concerns. This landmark legislation presented a more organized and comprehensive approach to the delivery of health care services in Native American communities. Subsequent reauthorizations have amended the Act to reflect advancements in health care delivery, respond to the desire of tribes for greater responsibility of programs and to target the high incidence of certain diseases that have plagued this segment of the American population.
"Unfortunately, the current authorization of the Indian Health Care Improvement Act expired six years ago. While there have been attempts to reauthorize the Act since then, legislation has usually languished in the Congress or been stymied by those who are opposed to certain provisions within the bill.
"But that is no longer the case. Today, we are moving forward on this important bill and I am proud to say that today’s mark up in the Subcommittee is a critical step forward in making sure this bill is signed into law this Congress.
"The bill’s primary objective is to improve access to quality medical care for American Indians and Alaskan Natives. The basic framework of the Indian Health Care Improvement Act has been retained, including its provisions that target diseases for which Indian Country shows an astonishingly high rate.
"The bill, as introduced, would also authorize far more efficient and cost-effective methods of health care delivery; provide a greater role for tribes to play in the delivery of health care services; and amend the Social Security Act to improve access to crucial health care programs such as Medicare, Medicaid and SCHIP.
"As I said in the hearing we held back in June, it is my intention to not only have a bill reported out of Committee, but have a bill that can clear both chambers and win the President’s approval. To that end, we have been working diligently over the past several weeks with tribal stakeholders, the Administration, and the minority to address outstanding concerns and make revisions.
"Later, I will offer a manager’s amendment that incorporates many of the changes that we were able to agree on. While we were not able to agree on every issue, I am proud to say that I believe we all have been working in a good faith effort to report out a bill that the entire Subcommittee can be proud of and I want to thank the minority for working with us to achieve that goal.
"In closing, I just want to explain why this is such an important issue. First and foremost it boils down to the fact that it is our legal obligation under the constitution and the treaties our government has entered into with the sovereign Indian nations to provide them with quality health care services.
"But it is also our moral obligation. For anyone who has not visited an American Indian reservation and assessed the health care facilities and services that exist in these communities, I think you would be stunned. Today we have a chance to change all that and I hope my colleagues would support me in that effort. Thank you. I would now like to recognize my good friend, Mr. Deal, for the purpose of making an opening statement."
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