Secretary Sebelius Promises Improved Health Care For Native Communities

HHS Secretary Kathleen Sebelius (

Health and Human Services Secretary Kathleen Sebelius says she will launch a new multiyear effort to improve health care for Native Americans, calling previous federal programs a "historic failure."  Recruitment of health care providers for reservations and preventive care for Tribal members are top priorities. "(We need to) begin to lay the groundwork with Congress right now to say here's where we need to be," Sebelius said. "I think often the Tribal issues just fade away."

Dating back to a treaty signed in 1787, the federal government assumed an obligation to provide Native Americans with health care on reservations. Yet the chronically-underfunded Indian Health Service only has about half of the money it needs, often leaving Tribes in remote areas with severely substandard care.

President Barack Obama campaigned notably in Tribal communities and promised better health care for Native Americans. The 2010 federal budget includes an increase of $454 million, or about 13 percent, for IHS funding and the stimulus bill signed earlier this year provided for construction and improvements to health clinics on reservations.

Nevertheless, Sebelius says the funding increase still falls well short of the IHS’ actual needs. "One of my challenges to the new head of the Indian Health Service is that we need a multiyear strategy, we need an end goal," she said. "The most severe disparity between quality care and what goes on with health outcomes is in the Native American population."

Health Care Legislation For Native Americans On Hold

Congress is expected to adjourn in December without sending a wide-ranging health care bill focused on Native Americans to President Bush, leaving Senate Indian Affairs Committee Chairman Byron Dorgan and Native American leaders to seek support from the incoming administration of President-Elect Obama. The bill was passed by the Senate earlier this year, and is likely to reappear in similar form in the next Congress.

The legislation would authorize expenditures of approximately $35 billion for Native American health care programs over the next 10 years. It would give Native peoples increased access to health care services, including screening and mental health programs. It also provides for funding increases for the federal Indian Health Service, subsidizes new construction and modernization of reservation-based health clinics, and promotes the recruitment of Native Americans into health professions. The bill also would increase Tribal access to Medicare and Medicaid.

Senate Indian Affairs Committee Chairman Byron Dorgan attributed the bill’s failure to a dispute over abortion funding. He said its passage through the House was complicated by an amendment added by Sen. David Vitter, R-La., that would bar any money authorized in the legislation from being used for abortions.