Federal Indian programs have been added to the “high-risk” category by the Government Accountability Office. That designation could not come at a worse time because there are already so many pressures to cut the budget. And that’s exactly the wrong way to serve Indian Country.
This is Trahant Reports.
The GAO zeroes in on federal programs that it says are vulnerable to fraud, waste, abuse, mismanagement, and, the need for transformation to address economy, efficiency, or effectiveness challenges. The Bureau of Indian Education, the Bureau of Indian Affairs and the Indian Health Service made that list for the first time.
GAO says the BIA is slow to approve energy projects. Congress can’t wait to make the approval process faster than filling your car with a tank of gas. But that will have unintended consequences for the very notion of trust land, tribal control of energy projects, and the challenges of global warming.
Next the GAO says the Bureau of Indian Education needs to better manage. Only problem: Hiring for BIE schools is easier said than done. There is another problem at play: Conservative think-tanks have these as “failing schools” and would replace them with a whacky scheme to create Education Savings Accounts.
The third high-risk agency identified by the GAO is the Indian Health Service. It says to help ensure that Indian people receive quality health care the IHS should improve quality and make better hires. Absolutely. Of course the IHS is trying to improve quality and make better hires. The problem is mostly funding.
Another GAO recommendation about IHS might be the most tone deaf. It says, “we recommend that IHS realign current resources and personnel to increase capacity to deal with enrollment in Medicaid and the exchanges and prepare for increased billing to these payers.”
Congress is going in exactly the opposite direction. The serious questions, the one that Congress ought to be answering, are how much will it cost IHS when Medicaid is turned into a block grant? And, if there are to be block grants, will states even fund a federal health care delivery system?
The GAO report makes a big deal about IHS developing a fair method for how it spends money on purchased and referral care.
What the report should have said is that Congress is to blame. The problem is not the architecture; it’s the funding. No federal agency. No state agency. No private medical system spends less than the Indian health system on a patient. The real problem is that it’s impossible to defy gravity.
I am Mark Trahant.
The Trump administration has been in office for less than a month — and already the construction of the Dakota Access Pipeline is once again proceeding. Company officials say oil will be flowing by June.
This is Trahant Reports.
There is a flurry of activity around the Dakota Access Pipeline. The project has cost more than $3.8 billion to transfer oil from North Dakota to markets in Illinois and beyond.
Yet every action to build the pipeline is met with many more reactions to stop it.
The fight about this pipeline — and the broader issues it represents — is far from over.
Of course some days it does not seem that way. The U.S. Army Corps of Engineers approved the final easement for the pipeline to cross under the Missouri River and complete the project.
The Standing Rock Sioux Tribe said if the construction is successful “the tribe will seek to shut the pipeline operations down.” IT has also called for a march in Washington, DC, on March 10th.
Then President Trump lives in a world where none of this is a big deal. “I don’t even think it was controversial,” he said. “I haven’t had one call.”
Of course the White House wasn’t taking calls.
So the Center for Investigative Reporting and its Reveal News has created a phone number to solicit voice mails from the public about what they would tell the president. (It’s 510-545-2640). This is your opportunity to sound off.
Another challenge is a financial one. Many individuals, tribes, cities, and companies are pulling their money out of the banks that finance the Dakota Access Pipeline.
But that’s really just the beginning. Rebecca Adamson, founder of First Peoples Worldwide, points out to investors how much capital they are losing by investing in companies that operate without the consent from the community involved. She pegs this as a real cost, somewhere between $20 million to $30 million a week.
Just look at how much money has been wasted on law enforcement at Standing Rock and you get a sense about how big a number that could be. Clearly it’s better to partner with tribal communities.
I also have a big idea.
So we know the project will take some 60 days to complete. And about three weeks to actually transfer oil from North Dakota to the end of the pipeline.
What if on that day, the day the oil reaches markets, there is a Day Without Oil? One day. It will take a massive organizational effort. But why not? What if every ally of Standing Rock, every community that has its own Standing Rock, everyone who is concerned about water, just takes a day off from oil? Either walk every where that day — or just stay home. Do what it takes to remind the companies, and the government itself, who’s really in charge of the economy.
I am Mark Trahant.
A Native American journalist is arrested while covering Standing Rock.
This is Trahant Reports.
There is an idea in law enforcement called the “thin blue line.” It basically means that police work together. A call goes out from Morton County and, right or wrong, law enforcement from around the country provides back up.
You would think journalism would be like that, too.
When one journalist is threatened, we all are. We cannot do our jobs when we worry about being injured or worse. And when a journalist is arrested? Well, everyone who claims the First Amendment as a framework should object loudly.
Last Wednesday Jenni Monet was arrested near Cannonball, North Dakota. She was interviewing water protectors who were setting up a new camp near the Dakota Access Pipeline route on treaty lands of the Great Sioux Nation. Law enforcement from Morton County surrounded the camp and captured everyone within the circle. A press release from the sheriff’s Department puts it this way: “Approximately 76 members of a rogue group of protestors were arrested.” Most were charged with criminal trespassing and inciting a riot.
As was Jenni Monet.
She is facing serious charges and the judicial process will go forward. The truth will come out.
But this story is about the failure of journalism institutions.
The Native press and the institutions that carry her work had Monet’s back. That includes Indian Country Media Network, Yes! Magazine, and the Center for Investigative Reporting. The Lost Angeles Times has now weighed in with its own story written by Sandy Tolan who’s done some great reporting from Standing Rock.
But in North Dakota you would not know this arrest happened. The press is silent.
After her release from jail, Monet wrote for Indian Country Media Network, “When Democracy Now!’s Amy Goodman was charged with the same allegations I now face—criminal trespassing and rioting—her message to the world embraced the First Amendment. ‘There’s a reason why journalism is explicitly protected by the U.S. Constitution,’ she said before a crowd gathered in front of the Morton County courthouse. “Because we’re supposed to be the check and balance on power.”
The funny thing is that journalism institutions were not quick to embrace Goodman either. I have talked to many journalists who see her as an “other” because she practices a different kind of journalism than they do.
Monet’s brand of journalism is rooted in facts and good reporting. She talks to everyone on all sides of the story, including the Morton County Sheriff and North Dakota’s new governor. She also has street cred … and knows how to tell a story.
So if we ever need journalism institutions to rally, it’s now. It’s not Jenni Monet who will be on trial. It’s the First Amendment. Journalism is not a crime. I am Mark Trahant.
How does Indian Country survive the Donald Trump era? The new administration is only a few days old and already the chaos of the times have upset business as usual. And possibly the very structure of federal-Indian law.
This is Trahant Reports.
Don’t count out the bureaucracy. I first started covering federal Indian policy during the late 1970s. I was in DC and was interviewing someone about a reform project at the Bureau of Indian Affairs, a plan that I thought made a lot of sense. But my source smiled and responded, “I have seen them come. I have seen them go.” There are ways to tie up initiatives — even good ones — through the process of government.
President Donald J. Trump’s memoranda might fit into this category. Usually an executive order or a memorandum has a legal framework as part of the document, including citing the statutory authority for the presidential action. On Dakota Access and Keystone that reference has been replaced by the logic of “because I said so.”
We shall see.
Tribes should work closer with cities, states, private companies, and any global government that’s open to help. The federal government is going to be close to useless for the next four years (unless the Trump infrastructure program happens, and includes Indian Country, but there is no evidence of that yet.) The modern city state, think a Seattle, Portland, Minneapolis or a Phoenix, are the real engines of growth in this country. What’s the best way for tribes to become partners?
Indian Country’s greatest advantage right now is our young people, more than 40 percent of our total population (compared to about a third for country as a whole.) We have numbers working in our favor and we should look for more ways to leverage that advantage.
Don’t count out Republican versus Republican. Right now Republicans in Congress are giving President Trump the benefit of the doubt. But as decisions get harder, the act of governing gets more complex.
There is already evidence of this in the debate about repealing the Affordable Care Act. The idea of getting rid of Obamacare was a unifying force. But there is no consensus about a replacement law. Republican governors fear that their state budgets will collapse if Medicaid becomes a block grant with less money. And many Republicans in Congress cling to the idea that health care should be left up to families and government should not be involved or fund it. And finally Republicans who want to win the next election know that stripping heath insurance from millions of people is not a winning hand.
There are many ways for tribes to survive the Trump era. Only … it’s time to think differently. I am Mark Trahant.
Congress has voted to repeal the Affordable Care Act. Kinda, sorta. Because it’s actually way more complicated than a straight repeal of the law.
This is Trahant Reports.
The House and Senate passed budget resolutions that instruct four committees in Congress to strip funding from the budget.
Yet the details of that repeal — including what it actually means for the Indian Health Care Improvement Act, a chapter of the law — remain unclear.
And to make matters even more complicated President-elect Donald Trump told The Washington Post Sunday that he wants to replace the Affordable Care Act with insurance for all. What ever that means. Hard to imagine that Republicans in the House will go along. Trump told the Post that Medicaid cuts are not a part of his plan.
So far the actually legislative proposals go the opposite direction and target tens of billions of dollars that states now get for Medicaid expansion. It’s likely that any replacement will be some kind of block grant program that sends a set amount to states instead of funding every eligible person.
There is a long way to go before the repeal becomes law (and an even longer path ahead for any replacement).
First: There is something Indian Country can do, right now. There is still time to sign up for Medicaid, Medicaid expansion, the Children’s Health Insurance Program, and insurance found on the exchanges. This is money that will benefit the Indian health system for at least a year and as long as four years. This act of defiance will not only bring money to a local clinic or hospital, but it will pressure state lawmakers to find a solution for the people who already have Medicaid.
The Affordable Care Act in Indian Country has been a steady success. The law did not result in immediate full funding for Indian health. (In fact: I think the Indian Health Service could have done a lot more to sell the insurance programs to individuals.) Nonetheless Medicaid collections in the Indian Health Service budget have increased by more than 50 percent since the law was enacted. There are still far too many patients in the Indian health system who are uninsured. (Yes, I know, a treaty right, but one that’s not fully-funded.) The fact is patients who carry health insurance, including Medicaid, have more options in terms of care, especially when patients need treatment or specialists outside of the Indian health system.
This Sunday was another deadline for people to sign up for insurance through the exchanges. But American Indians and Alaska Natives are exempt from that deadline.There are plans that cost nothing. And signing up now is an act of defiance.
Remember there will be a transition once Congress comes up with a replacement. Adding more people to the rolls of insurance now is one way to demand that Congress come up with an alternative and not just destroy what’s in place.
I am Mark Trahant.
State legislatures are convening around the country this month and Native Americans are in key leadership positions in at least seven states. That’s impressive — and critical right now because of the types of conversations that will be going back and forth between Washington, D.C., and state capitals about Medicaid, health care and energy policy.
What should Indian Country be watching for in a Donald Trump administration? Let’s explore four policy challenges. This is Trahant Reports.
Trump supporters see the president-elect as a new champion of tribal sovereignty, especially when the focus is on energy development. The problem with this is that folks who think fossil fuels are our future are on the wrong side of history. In order to buy the logic of more oil, gas, and coal, you have to pretend that climate change is neither real nor human caused. The trade off requires believing that profits and perhaps a few jobs are better measures than science. And, to do this at a time when the rest of the planet is moving on. Linking Indian Country’s future to fossil fuels locks us into declining technology and shrinking markets.
One area where a Trump administration could really help Indian Country is infrastructure. The president-elect has called building roads, water systems, electricity grids, and telecommunications “a golden opportunity for accelerated economic growth.” But the plan has two serious obstacles for tribal nations. Trump promises to use private partnerships to pay for these projects. And, he wants the initiative to give “maximum flexibility to the states.”
That brings me to the two greatest challenges ahead in a Trump administration, repeal of the Affordable Care Act and severe budgets.
Repealing the Affordable Care Act, or Obamacare, will likely be the first vote in Congress. Repeal is the easy part. “Then what?” It is a much more difficult question.
The Indian Health Service has been historically underfunded. But the Affordable Care Act has added money, especially through Medicaid expansion. And it’s important to remember that the Affordable Care Act has substantially reduced the number of uninsured Americans, including American Indians and Alaska Natives. Here is one number to think about: More than half (51 percent) of Native children are insured via Medicaid and the Children’s Health Insurance Program. This is important because those who have insurance are more likely to get a broader range of health care services than those who only rely on IHS for care.
So depending on how the repeal and replace legislation unfolds between 11 million and 60 million people could lose health insurance coverage. And the Indian Health system could lose hundreds of thousands of dollars in funding streams.
Then the issue of money for American Indian and Alaska Native programs might be the toughest one of all. President-elect Trump’s choice for the Office of Management and Budget is Rep. Mick Mulvaney, R-South Carolina. He’s one of the most strident voices in Congress against federal spending (even voting against his own party when budgets were not harsh enough).
Mulvaney defended the 2013 sequester — a disaster in Indian Country — as something that “bodes well for the future.”
“We are, all of us … having a national dialogue about what is really important for our government, and what our government could do without,” Mulvaney wrote. “And it has been much too long since we have done that.”
That conversation will define 2017. I am Mark Trahant.