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Federal cuts threaten healthcare system for Alaska Natives

Dermot Cole

FAIRBANKS -- The 10-year federal “sequestration” plan of steady cuts could devastate the healthcare system that Alaska Natives rely on, speakers at a conference of tribal leaders said Wednesday.

A 2011 law approved by Congress called for spending cuts of about $1 trillion over a decade, with most of the reductions in the so-called “discretionary” portion of the federal budget.

The Indian Health Service had a $228 million budget cut this year, with more to come each year, while the Veteran’s Administration medical system, as well as Medicaid and Medicare, escaped the sequestration knife. The IHS works with tribal organizations to provide healthcare services to 142,000 Alaska Natives at health centers, clinics and hospitals, costing several hundred million dollars every year.

Victor Joseph, the health director for the Tanana Chiefs Conference, said if the automatic budget cuts to the Bureau of Indian Affairs and other agencies continue, the impact will be enormous.

“I’ve become very worried about sequestration and the hit that it’s going to have on our organizations, our agencies and on tribes,” he said during a public comment period at a meeting of tribal leaders.

“Whether it’s BIA or health services, over a 10-year period, it’s going to basically deplete all of our ability to provide care to our people, already in a situation that it’s hard for us to meet the needs of our people,” he said.

“We really need to push our congressional body to do something more about sequestration,” he said. “I know nobody wants to talk about it there, but we have to talk about it.”

One solution is to advocate for a change so that IHS would be insulated, like Medicaid and Medicare, from the automatic cuts.

Ed Thomas, the president of the Central Council of Tlingit & Haida Indian Tribes of Alaska, said that Native American groups did not holler enough when the federal Office of Management and Budget decided that the Indian Health Service would face annual reductions. He said that the Department of Justice or the courts, not the budget office, should have made any decision on that issue.

Overall, he said that budget cuts are targeting the "discretionary" slice of the federal budget that is less than 15 percent of the total.

“If you look at sequestration and you look at the amount of cutbacks that are coming down you’re trying to balance the entire nation’s budget on that little sliver,” said Thomas.

He gave an overview of the federal spending situation to tribal leaders, saying that domestic discretionary spending has been growing more slowly than any other part of the budget, yet it is taking the biggest hit.

The conference was among the activities preceding the official start of the Alaska Federation of Natives convention Thursday.

On Wednesday, Julie Kitka, president of AFN, spoke to tribal leaders from across Alaska in the David Salmon Tribal Hall, as did representatives of the congressional delegation and officials of the National Congress of American Indians.

Thomas said that Alaska tribes will see a greater impact than Lower 48 tribes from federal cuts because of the greater dependence on federal budgets in Alaska.

Thomas said the tax cuts approved under President George W. Bush contributed nearly 50 percent to the increase in the deficit because revenue declined, but spending didn’t.

He said Congress doesn’t have the motivation to solve the problem because “everybody wants a balanced budget, but nobody wants to sacrifice anything.”

Dermot Cole can be reached at dermot(at)alaskadispatch.com. Follow him on Twitter @DermotMCole