Monday, September 28, 2009

Indian Health Service underfunded and overtaxed

The Indian Health Service is vastly underfunded and overlooked in the current health care debate, Mark Trahant writes for the Daily Yonder. Several members of Congress were critical of the "historic under-funding of IHS" at the National Indian Health Board Consumer Conference last month, Trahant reports. He writes they all conveyed the same message: "The United States made a health care promise to Native Americans and it’s wrong to fund a system with substantially less money than what is spent per person on health care for federal prisoners."

Funding of the IHS is so low that many patients are counted as part of the uninsured population in government data, Trahant reports. The Obama administration has added 13 percent to the IHS funding request, but Trahant writes neither the administration or Congress has made funding parity a priority. In response to the under-funding, many tribes have contributed their own money to pay extraordinary medical bills of members or provide members health insurance. The Internal Revenue Service has told tribes they must demonstrate these policies are need based or it will consider them taxable benefits.

Congress could clarify the law, allowing tribal members to receive the same benefits as tribal employees, or the IRS could issue a "revenue ruling" to treat tribal health insurance like the Veterans Administration or Medicare to fix the taxation problem. Trahant, a member of Idaho's Shoshone-Bannock tribes and a Kaiser Media fellow on assignment covering the IHS for a year, writes: "For once, it seems, there ought to be enough consensus in Washington to force the easy route. This is common sense. The IRS ought to get a call from the White House and the treasury secretary and be told to resolve this issue quickly." (Read more)

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