House and Senate negotiators have reached a deal on a budget resolution. That agreement then would go to each House for a vote. (An outcome that is not certain.) But, if it passes, it would be the first budget enacted by Congress in six years.
Let’s be clear about this plan: It would require deep spending cuts in federal Indian programs.
While the budget itself is not law, it sets limits for each of the appropriations committees to follow. According to a report from The Associated Press the draft document adds some $40 billion to military spending and calls for deep cuts to all domestic programs, including the Bureau of Indian Affairs and the Indian Health Service.
“The plan sets broad budget goals but by itself has little teeth; instead, painful follow-up legislation would be required to actually balance the budget,” the AP said. “It also permits the GOP majority to suspend the Senate’s filibuster rule and deliver a special measure known as a reconciliation bill to Obama without the threat of Democratic opposition. Republicans plan to use the special filibuster-proof bill to wage an assault on Obama’s Affordable Care Act rather than try to impose a variety of painful cuts to Medicare, Medicaid, food stamps, student loans, and other so-called mandatory programs over Obama’s opposition.”
The House budget is blunt about the next steps required to balance the budget within a decade, including repeal of the Affordable Care Act. “None of the reforms proposed in this budget will be able to solve the underlying challenges in our health care system so long as Obamacare remains on the books. Our budget fully repeals Obamacare,” according to the budget plan.
This very notion sets up an debate. President Barrack Obama would need to sign any appropriation into law — so a veto threat has merit. But the Congress still must pass a bill to appropriate money that would defy their own budget rules on programs such as the Indian Health Service (because some of thatagency’s authorizing legislation is the Affordable Care Act. Remember: The Indian Health Care Improvement Act is a chapter of the ACA.)
This debate is going to be difficult to resolve.
At the same moment that the Congress is pursuing its latest “repeal” of the Affordable Care Act more states, even states controlled by Republicans, are moving forward with an expansion of Medicaid. This may be the most important part of the Affordable Care Act, especially for Indian Country because it’s adding new dollars to the underfunded health care system. Montana is the latest state to expand Medicaid.
A new report by the Kaiser Family Foundation says hospitals in states with Medicaid expansion are reporting a significant decrease in uncompensated care and a boost from Medicaid revenue. “Overall,” the report said, “hospitals in Medicaid expansion states saw increased Medicaid discharges, increased Medicaid revenue, and decreased cost of care for the poor, while hospitals in non-expansion states saw a very small increase in Medicaid discharges, a decline in Medicaid revenue, and growth in cost of care to the poor.”
In past budget years, American Indian and Alaska Native programs have been able to get support from the appropriations committees, but in this cycle there will be less flexibility because of the instructions in the budget. The ranking Democrat on the House Appropriations Committee, Rep. Nita Lowey from New York, said the “Majority’s allocations, which are based on the House budget resolution that passed on a party-line vote, are insufficient and fundamentally flawed.”
She said: “The Interior bill’s allocation paints a similar picture with an allocation that is $246 million below the FY 2015 enacted level. We will still have to cover the increased costs to combat deadly wild fires, provide contract support costs in the Indian Health Services, and prepare for Centennial anniversary of the National Park Service, all from an allocation below last year.”
This budget resolution would cut deeper than even the sequester. As Lowey said in a press release, “I think my colleagues on the other side generally agree that sequestration was a failure, and a return to those sequester-level caps threatens important defense and non-defense priorities alike.”
The Republicans have yet to identify specific spending numbers based on their budget targets.
No Democratic votes are required in either the House or the Senate to enact this budget resolution. The president does not need to sign the resolution, but he will need to sign into law any future appropriations based on the spending plan.
Mark Trahant serves as the Atwood Chair at the University of Alaska Anchorage. He is an independent journalist and a member of The Shoshone-Bannock Tribes. For up-to-the-minute posts, download the free Trahant Reports app for your smart phone or tablet.