Coalition Ltr to House: Reauthorizing the Indian Health Care Improvement Act

June 23, 2008


Dear Representative,



As members of organizations concerned with faith, ethics, and commitment to the welfare of human kind, we ask your consideration of a bill to meet the essential health needs of Native American communities.



The Indian Health Care Improvement Act (IHCIA) provides the authority for the programs of the federal government that deliver health services to Indian people. IHCIA was last reauthorized in 1992. Since then, the American health care system has evolved with an increased emphasis on wellness and prevention. Many services are now provided outside of hospitals. Programs such as clinics, in-home health care for the elderly, long-term-care, and hospice are available in most communities. Yet, services for Native Americans have not been expanded. American Indians and Native Alaskans--who often reside in the most isolated and poorest areas of the country--will benefit if they can receive health care on the same basis as the U.S. general population. We look to the House to allow the critical task of modernizing medical services and systems for Native communities to begin.



Better medical care for Indian families is not a matter of self interest but of public interest and moral concern. The U.S. signed treaties promising health care in perpetuity in exchange for land or the laying down of arms. Our country must honor those promises. But historic obligations are not the only concern. Congress has committed to a goal of reducing health disparities that are so common between people of color and others in the larger society. The disparity in health conditions and health care between Native Americans and others is perhaps the most striking contrast in that whole picture. Public health professionals bring up a practical concern as well: diseases do not stop at the perimeters of tribal lands. Protecting the health status of every population in our country protects all other citizens.



For years, secular and faith groups have reached out to Congress to improve Indian health. Many in the religious community have sought to persuade members of Congress to focus upon the need to reauthorize IHCIA. Protestants, Catholics, and Jews have sent thousands upon thousands of messages of support for the updating of this Act. During this 110th session of Congress, we again worked to get reauthorization approved by the Senate. We celebrated the passage of S. 1200 in February.




H.R. 1328, a bill to amend IHCIA to revise and extend that Act, was introduced in March 2007 by sponsor Representative Frank Pallone, Jr. It has 58 sponsors. A hearing was held by the health subcommittee of the Energy and Commerce committee in 2007. The Natural Resources Committee reported the bill on April 4, 2008. The Energy and Commerce Committee and the Ways and Means Committee discharged the bill on June 6, 2008.



But now, the urgently needed Indian health legislation is being put on hold due to a behind-the-scenes debate over a potential abortion amendment. The Indian Health Service is already prohibited from performing abortions with the stipulations outlined in the Health and Human Services appropriations act (the Hyde amendment.) Native American organizations are imploring House members to “separate the IHCIA bill from the volatile and divisive abortion debate” and keep their focus on the shared values of addressing all health care needs, poverty, and access to services. We urge members of the House to put aside or reconcile differences and move on to reauthorize the important IHCIA.



We urge you to take initiative to ensure that this reauthorization, so long delayed, is passed by the House. Please voice your support for moving H.R. 1328 through the House on a bi-partisan basis. Members of both parties, congressional committees, federal agencies, and Indian leaders and organizations have labored for a decade to work out the details of this Indian health delivery system legislation. Earlier reauthorization bills made it to the “lame duck” sessions of the previous two congresses. The 110th Congress can finish the job and permit health improvements to begin in Indian Country






American Friends Service Committee


American Humanist Association


Church of the Brethren Witness/Washington Office


The Episcopal Church


Evangelical Lutheran Church in America


Friends Committee on National Legislation


Interfaith Center on Corporate Responsibility


Mennonite Church USA


Methodist General Board of Church and Society


National Advocacy Center of the Sisters of the Good Shepherd


NETWORK, A National Catholic Social Justice Lobby




Unitarian Universalist Association of Congregations


United Church of Christ, Justice and Witness Ministries