Tribes Must Prepare for the Financial Storm
[imgbelt img=tipiWhiteHouse320.jpg]The Obama Administration is following through on its pledge toward a ‘lasting conversation’ with tribal leaders. The second White House summit needs to set in place new systems for dispensing federal services.
[imgcontainer left] [img:obamtribalsummit320.jpg] [source]Getty via Jack and Jill PoliticsPresident Obama addressed the first White House summit of tribal nations last November, promising ‘a lasting conversation.’ The second summit will take place Dec. 16.
President Barack Obama set a high standard for tribal-federal relations last year. “Today’s summit is not lip service,” he said at the first White House Tribal Nations Conference, November 2009. “We’re not going to go through the motions and pay tribute to one another, and then furl up the flags and go our separate ways. Today’s sessions are part of a lasting conversation that’s crucial to our shared future.”
That lasting conversation is continuing as promised. It’s remarkable enough for a president and cabinet officers to meet with tribal leaders once during an administration — but this second round, to take place Thursday in Washington, D.C., suggests that the conference is now an annual event.
So what should we be saying about our shared future?
I’d use this as an opportunity to prepare for the coming financial storm — serious and long-term budget cuts that are coming from Congress — as a way to reconfigure federal services to Indian Country.
Take Medicaid and Children’s health programs. One of the best ideas coming out of the health care reform process is a feasibility study exploring the treatment of the Navajo Nation as a state. In tough budget times this is huge because state governments want to limit enrollment in Medicaid and Children’s Health Insurance to save money. But eligible American Indian and Alaska Natives do not cost the states money — it’s a 100 percent federal match. By moving the administration to the Navajo Nation, it makes it much more likely that eligible patients will be enrolled in Medicaid or Children’s Health adding critical revenue to the Indian health system.
The Navajo Nation feasibility project is only step one. This should be the beginning of a process that singles out other tribes, or regional associations, into administrative units that could manage Medicaid programs without a state roll. Or as I have put it before, treat Indian Country as a 51st state.
As the federal budget gets tighter and tighter it makes sense to look for ways to cut administrative costs. A small office directly funding tribal programs at the Centers for Medicaid and Medicare is a lot more efficient than distributing money through some 37 state programs when the end payment eventually goes to either the Indian Health Service or a tribal contractor anyway. (If pitched smartly, states might even like this idea.)
[imgcontainer left] [img:tipiWhiteHouse320.jpg] [source]PrensaA tipi on the White House lawn last November, during the first White House Tribal Nations Conference.