‘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
  • COMMUNICATIONS AND OUTREACH ASSOCIATE
    Communications and Outreach Associate Position Opening: www.westernlaw.org/communications-outreach-associate ************************************************* Location: Western U.S., ideally in one of WELC's existing office locations (Santa Fe or Taos, NM, Helena,...
  • FREELANCE GRAPHIC DESIGNER & PROJECT COORDINATOR (REMOTE)
    High Country News (HCN) is seeking a contract Graphic Designer & Project Coordinator to design promotional, marketing and fund-raising assets and campaigns, and project-manage them...
  • FILM AND DIGITAL MEDIA: ASSISTANT PROFESSOR OF INDIGENOUS MEDIA, CULTURAL SOVEREIGNTY AND DECOLONIZATION (INITIAL REVIEW 12.1.21)
    Film and Digital Media: Assistant Professor of Indigenous Media, Cultural Sovereignty and Decolonization (Initial Review 12.1.21) Position overview Position title: Assistant Professor - tenure-track Salary...
  • REAL ESTATE SPECIALIST
    To learn more about this position and to apply please go to the following URL.
  • ENVIRONMENTAL GEOPHYSICS
    "More Data, Less Digging" Find groundwater and reduce excavation costs!
  • RARE CHIRICAHUA RIPARIAN LAND FOR SALE
    40 acres: 110 miles from Tucson: native trees, grasses: birder's heaven::dark sky/ borders state lease & National forest/5100 ft/13-16 per annum rain
  • CENTRAL PARK CULTURAL RESOURCE SPECIALIST
    Agency: Oregon Parks and Recreation Department Salary Range: $5,203 - $7,996 Position Title: Central Park Cultural Resource Specialist Do you have a background in Archaeology...
  • STAFF ATTORNEY
    Come live and work in one of the most beautiful places in the world! As our Staff Attorney you will play a key role in...
  • ARIZONA GRAZING CLEARINGHOUSE
    Dedicated to preventing the ecological degradation caused by livestock grazing on Arizona's public lands, and exposing the government subsidies that support it.
  • OPERATIONS MANAGER
    Position Summary: Friends of the Inyo (friendsoftheinyo.org) is seeking a new Operations Manager. The Operations Manager position is a full-time permanent position that reports directly...
  • WATER RIGHTS BUREAU CHIEF
    Water Rights Bureau Chief, State of Montana, DNRC, Water Resources Division, Helena, MT Working to support and implement the Department's mission to help ensure that...
  • EXECUTIVE DIRECTOR
    The Amargosa Conservancy (AC), a conservation nonprofit dedicated to standing up for water and biodiversity in the Death Valley region, seeks an executive director to...
  • DEVELOPMENT & OUTREACH ASSOCIATE
    Southeast Alaska Conservation Council is hiring! Who We Are: The Southeast Alaska Conservation Council (SEACC) is a small grassroots nonprofit based out of Juneau, Alaska,...
  • DESERT LANDS ORGANIZER
    Position Summary: Friends of the Inyo seeks a Desert Lands Organizer to assist with existing campaigns that will defend lands in the California desert, with...
  • IDAHO CONSERVATION LEAGUE
    Want to help preserve Idaho's land, water, and air for future generations? Idaho Conservation League currently has 3 open positions. We are looking for a...
  • LUNATEC ODOR-FREE DISHCLOTHS
    are a must try. They stay odor-free, dry fast, are durable and don't require machine washing. Try today.
  • EVENTS AND ANNUAL FUND COORDINATOR
    The Events and Annual Fund Coordinator is responsible for managing and coordinating the Henry's Fork Foundation's fundraising events for growing the membership base, renewing and...
  • EDUCATION DIRECTOR
    Position Description: The Education Director is the primary leader of Colorado Canyons Association's (CCA) education programs for students and adults on the land and rivers...
  • 10 ACRES OF NEW MEXICO HIGH DESERT
    10 Acres of undeveloped high desert land in central NM, about 45 minutes from downtown Albuquerque. Mixed cedar and piñon pine cover. Some dirt roadways...
  • WATERSHED RESTORATION DIRECTOR
    $58k-$70k + benefits to oversee watershed restoration projects that fulfill our strategic goals across urban and rural areas within the bi-national Santa Cruz and San...