by Liz Ruskin
President Trump proposes to cut the Indian Health Service budget by $300 million, and the head of the IHS had trouble justifying that 6 percent cut at a Senate hearing Wednesday. Senators on both sides of the aisle say they’re outraged at the state of affairs at IHS, and it goes beyond the budget cut.
The acting IHS director would have had a rough hearing anyway. Chairman Lisa Murkowski and other members of the Interior Appropriations Subcommittee have spent years shaping the IHS budget. Some represent large Native populations. They weren’t likely to welcome cuts to drug abuse treatment, mental health services, clinics and hospitals in their states.
But just last week, the Wall Street Journal put a spotlight on the agency’s dire faults. Murkowski says she was horrified to read the Journal’s accounts of fatal misdiagnoses, and inept staff at IHS facilities in the Great Plains.
“Because this is our IHS,” Murkowski said. “These are our facilities that are supposed to care for our First People. And the stories that were detailed were shocking.”
Murkowski says she’s normally laser-focused on home-state issues, but Alaska’s Native health facilities are run by tribes, under contract to the IHS, so their problems aren’t the same. Murkowski, though, says, the national problems are far too big to ignore.
Sen. Steve Daines, a Montana Republican, suggested changing the name of IHS to ‘Indian Health Suffering.’
“These are real families–single moms, single dads, aunts, uncles, elderly tribal leaders –that are suffering greatly. It’s a tragedy.”
Acting IHS director Michael Weahkee acknowledged none of this in his statement at the hearing. He portrayed the proposed cut to his agency as small.
“(It) will allow us to maintain and address our agency mission to raise the physical, mental, social and spiritual health of American Indians and Alaskan Natives to the highest level,” Weahkee said.
Murkowski was incredulous.
“I know that your job is to defend this budget but I just have to say ‘wow’ after listening that,” she said. “I would think that we don’t have a problem within the IHS system”
Several senators expressed frustration IHS didn’t provide data on Medicaid reimbursements, the revenue IHS gets when it treats a Medicaid recipient. Murkowski says the information is important, because senators are supposed to vote soon on a health care bill that would cut Medicaid, without knowing the effect it would have on IHS.
Jon Tester, Montana’s Democratic senator, was calm when he started questioning Weahkee.
Tester: “Were you told not to answer any questions here by the way?”
Weahkee: “No. No.”
Tester: “Because I think it’s absolutely unbelievable that you can separate how much money that Medicaid has helped to a third party billing.”
Tester’s impatience built as he repeatedly tried to get the acting director to answer one specific question.
Tester: “What does this budget do to your ability to hire staff?”
Weahkee: “We have a lot of efforts under way ….”
Testser: “Is there an increase in dollars for hiring staff or decrease?”
After a few minutes of a fruitless back-and-forth, Tester became exasperated.
“I’m going to tell you something,” Tester said. “Indian Health Service is in a crisis. And if you have served in Indian Health Service for 10 years and you have answered the questions in Indian Health Service like you have today it’s no wonder that it’s in crisis. I cannot believe what has transpired in this hearing today. All I want is some damn answers.”
The White House hasn’t nominated anyone to head IHS permanently. Health Sec. Tom Price said at his confirmation hearing he was aware of problems at IHS and wanted to fix them.