‘Medicare for all’ would finally fulfill tribes’ treaty rights

The proposed plan is unlikely to pass, but would bolster the Indian health system.

 

This story originally appeared on Trahant Reports and is republished here with permission. 

Bernie Sanders is expected to introduce his version of health care reform, a plan he calls “Medicare for all.” At least fifteen Democrats have signed on as co-sponsors to the single-payer plan.

“This is where the country has got to go,” Sanders told the Washington Post. “Right now, if we want to move away from a dysfunctional, wasteful, bureaucratic system into a rational health-care system that guarantees coverage to everyone in a cost-effective way, the only way to do it is Medicare for All.”

Sanders’ bill has no chance in a Republican Congress. Yet the Vermont Independent is adding to the richness of the debate. He is showing a clear alternative to Republican plans (the latest is one by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La.)

But Indian Country should take note. Sanders’ bill would fully fund the Indian health system. Let’s do the math. The current budget for the Indian Health Service is $6.091 billion dollars. And of that, roughly $1.2 will come from Medicaid, Medicare and other insurance. This serves about 2.2 million American Indians and Alaska Natives in 39 states.

Sen. Bernie Sanders of Vermont speaking at a town meeting at the Phoenix Convention Center in Phoenix, Arizona, in 2015.
Gage Skidmore/Flickr

But if Sanders’ proposal for universal care were enacted every one of those 2.2 million patients would have funding from insurance. The national average for Medicare beneficiary is $10,986. The total: $24.191 billion. A four-fold increase (and this does not include appropriations, just insurance dollars). So if you include both, the total is roughly $30 billion.

This sound like an awful lot of money, right? That big number reflects what other health systems already spend. So actually it’s the ideal demonstration of just how underfunded the Indian Health Service is under current law and insurance schemes. This is what a fully funded Treaty Right looks like.

Of course some of this can be done now, even without Sanders’ bill. Many people in tribal communities are posting on Facebook exactly how to sign up for Medicaid (the government insurance program that so many in Indian Country already qualify for.) They are doing this as an act of defiance, because the Trump administration has recently quit advertising the program and is not actively promoting sign-ups.

But, again, let’s do the math. If every American Indian and Alaska Native was eligible for Medicaid that would net the Indian health system about $7.211 billion (instead of the $1.2 billion from third-party billing now). I actually think this is a more realistic number (even under a Sanders plan) because it does not include some of the spending by Medicare (and for that matter, Medicaid) on senior citizens. The national average for Medicaid is a modest $3,278 for an adult and for $2,577 average for children. The total for IHS would be in the neighborhood of $15 billion. More than double what is spent now.

Either Medicare or Medicaid: This is what full funding looks like. And a Treaty Right fulfilled. Finally.

Speaking of children, the Senate has reached a bipartisan deal in the Senate to reauthorize the Children’s Health Insurance Plan or CHIP. This insurance plan covers 9 million young people through Medicaid. The program is set to expire at the end of the month unless Congress acts and then President Donald J. Trump signs a new legislation into law.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. On Twitter @TrahantReports

Note: An earlier version of this article incorrectly identified Sanders as a Democrat. He is an Independent who caucuses with Democrats.

High Country News Classifieds
  • NEWS DIRECTOR
    Based in the state capitol, Boise State Public Radio is the premier NPR affiliate in Idaho. With 18 transmitters and translators, it reaches 2/3rds of...
  • INTERNET-BASED BUSINESS FOR SALE
    Dream of owning your own business, being your own boss, working from home ... this is the one.
  • EXECUTIVE DIRECTOR FOR MOJAVE DESERT LAND TRUST
    Organization Background: The Mojave Desert Land Trust (MDLT) is a non-profit 501(3)(c) organization, founded in 2006. Our mission is to protect the ecosystems of the...
  • EXECUTIVE DIRECTOR
    If you are deeply committed to public service and would like to become part of our high performing, passionate and diverse team, NCAT is looking...
  • TRIPLEX .8 ACRE KANAB, UT
    Create a base in the center of Southern Utah's Grand Circle of National Parks. Multiple residential property with three established rental units and zoning latitude...
  • FORGE & FAB SHOP
    with home on one beautiful acre in Pocatello, ID. Blackrock Forge - retiring after 43 years! Fully equipped 5,500 sf shop including office, gallery and...
  • SMALL FARM AT THE BASE OF MOUNT SHASTA
    Certified organic fruit/berry/veggie/flower farm. Home, barns, garage, separate apt, more. Just under 2 ac, edge of town. Famously pure air and water. Skiing, mountaineering, bike,...
  • FOREST STEWARDSHIP PROJECT DIRECTOR
    Become a force for nature and a healthy planet by joining the Arizona Chapter as Forest Stewardship Project Director. You will play a key role...
  • EXECUTIVE DIRECTOR
    Ranchers Stewardship Alliance is accepting applications for an Executive Director. This position will provide leadership to RSA, develop a fund raising plan, and effectively communicate...
  • WRITING PLACE: THE ANIMAS RIVER REGION WRITING WORKSHOP
    REGISTER ONLINE BY: Friday, June 15 WHERE: Durango, CO (location TBD) WHEN: Monday, July 16 Youth workshop: 10 a.m. - 12 p.m. (18 and under,...
  • EQUITY IN THE OUTDOORS COORDINATOR
    The Equity in the Outdoors Coordinator will lead community engagement, program implementation and development, and data collection for the Eagle Valley Outdoor Movement (EVOM). EVOM...
  • COMMUNITY ENGAGEMENT ASSISTANT
    The Idaho Conservation League is seeking a personable individual who is passionate about conservation to join our Sandpoint Field Office. The Community Engagement Assistant will...
  • LIGHTWEIGHT FLY ROD CASES
    4 standard or custom lengths. Rugged protection for backpacking. Affordable pricing.
  • EXPERIENTIAL EDUCATION INTERN/ASSISTANT
    Actively introduce students to Experiential Education, Outdoor Recreation, and Sustainability while engaging and challenging them to learn and participate in these diverse opportunities. Room, board,...
  • ENVIRONMENTAL INVESTIGATIVE MEDIA SERVICES
    In-depth investigations of polluters, lobbyists, regulators, elected officials and others focused on environmentally damaging projects in the U.S. and internationally. We specialize in mining projects,...
  • UNDEVELOPED 40 ACRES - SOUTHWEST COLORADO
    in beautiful Montezuma County.
  • TRUCK DRIVER
    Class A & B drivers, pass all DOT requirements and clean driving record
  • MARIA'S BOOKSHOP FOR SALE
    - Thriving Indie bookstore in the heart of Durango, Colorado. General bookstore with 34-year history as a community hub for Southwest region of CO. 1800...
  • ASSOCIATE DIRECTOR OF DEVELOPMENT
    HawkWatch International seeks an experienced fundraiser to join our awesome team! This position will provide support in all aspects of the department. We are looking...
  • DIRECTOR OF DEVELOPMENT
    will develop and execute Wild Utah Projects fundraising plan. Call, email or check full description of job online for more details: