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Editorial Note: The word “Indian” is used in this article only in context of quoting the Government or Agency names and the agency’s statement of its mission, I have used the word “Native” to describe this group of people outside of that specifc instance. If my word choice is inaccurate, outdated, or offensive and you would be willing to educate me on how to properly write on this topic, please let me know and I will gladly learn, edit accoringly, and update this note to educate my readers. Thank you.
What is The IHS?
I write you from Day 24 of the Partial Shutdown, still no progress, still no solutions. McDonald’s is being served to the Clemson Tigers in the White House as I type. But, we have more important things to discuss tonight, this one is hard, I’m leaving most of my jokes behind, and working hard to reign in my snark. Strap in.
Let’s talk about a little agency that rolls up under the currently unfunded Department of the Interior, The Indian Health Service (IHS). The IHS provides federal health services to Native people throughout the US. The provision of health services to members of “federally-recognized tribes” grew out of the special government-to-government relationship between the US Federal Government and the sovereign Governments of each native tribe. This relationship, dating back to 1787 is based directly in our Constitution (Article 1, Section 8) and has been given substance through many treaties, laws, SCOTUS decisions, and Executive Orders throughout our nation’s history. This is a history and relationship fraught with hardship, wrong-doing, oppression, and mistrust.
What Does IHS Do?
Where Do They Work?
This budget covers the provision of health benefits for 2.5 million native peoples, for a recent cost per patient of less than $3,000 (no that’s not missing any zeros, yes it is less than it costs me to insure and provide healthcare for my family of three for two months).
Budget PROBLEMS Aren’t New to IHS
As a small and hollow comfort if you are shocked and appalled by that number, the current IHS director was in a bit of hot water with Congress and was chastised during Appropriations Subcommittee hearings by Senator Jon Tester (D-MT) for refusing to answer repeated direct questions about whether the 2018 budget proposal was adequate to fulfill the mission.
Before we move on, you should know: It’s hard to blame Director Weahkee for not answering though, because when talking about the IHS budget you absolutely MUST remember that in 2013 the IHS experienced a funding cut that took around $800 Million from their budget (Thank you, Sequestration) they’ve not returned to their previous funding levels. The Director has a big hill to climb and very little help doing it.
What’s Happening Now?
Here’s what that says for those who don’t speak fluent Government (a class I offer, by the way): We have determined that the services you, as a tribe, provide under this agreement with the Federal Government to be imperative to the public health and saftey, so those services must continue through the shutdown. HOWEVER (emphasis mine), we will not be making any payments until we are funded again. So, please keep doing the work, we will pay you when we figure this out.
Essentially, it means yes, we know this is of vital importance, no we don’t have a better answer than this.
To Be Continued…
About The Author
Elizabeth DeBiase, CF APMP, has spent her life immersed in the GovCon community. She has helped government contractors – from entrepreneurs to Fortune 100 companies – navigate the arcane and complex regulations that govern the process of winning and managing government contracts. Today, Liz is the majority owner of TWRG, and dedicates her time to making sure the truly ethical