Wednesday, March 12, 2008

Native American Affairs: One Step Back?

March has always seemed to me to be a month of transition. It is the month in which we move from winter to spring in the northern hemisphere. Shakespeare immortalized the fifteenth day of the month – the Ides of March – as the day Caesar was murdered, touching off the wars that eventually changed Rome from a republic to an empire. In the Christian calendar, Easter – a transitional event – can fall in March – this year it is March 23rd. And of course every person who can lay claim to Irish ancestry as well as the multitudes that are Irish for a day observe March 17th – St. Patrick’s Day.

This year, March 31st is a transition day of another sort. It is the last day that the states can apply for a temporary waiver, good through the end of 2009, to the “Real ID” law passed by Congress in 2005 in one of its post-9/11 “security spasms.”

The good news is that all but four states – Montana, Maine, New Hampshire, and South Carolina – have applied for or already have waivers in hand. The justification for delaying implementation of the program is the sheer complexity of designing a system capable of finding, recognizing, and processing a plethora of official and unofficial documents and affidavits that in prior years were “good enough” for states to issue driver’s licenses or identity cards. The 2005 law further requires states to design the cards so that they can be read by officials in all states and by federal bureaucrats.

Already the effects of this legislation, approved as an amendment to the 2005 Iraq war supplemental spending bill, are being felt in communities across the country as state bureaucracies that receive and distribute federal funds spend money and time on administrative re-design rather than on client needs. Moreover, the states cannot be sure that what they are designing won’t be overturned by regulations from federal agencies and departments such as Homeland Security (for air travel) or Health and Human Services (Medicaid).

The irony of this madness to be “100 percent” secure from an act of terror or to ensure illegal immigrants do not access social services is nowhere more explicit than when Native Americans – arguably the only non-immigrant part of the population – are involved. Within the last week, two different publications have highlighted the degree of discrimination already suffered by Native Americans who do not possess the “right credentials” for entering federal buildings, for air travel, or to receive health care payments through Medicaid.

The discrimination may not be overtly targeted at Native Americans, but their large presence among the nation’s poorest and most disadvantaged group effectively translates into practical discrimination. The extent of the problem may come into focus later this year when Medicaid recipients attempt to recertify their eligibility for Medicaid as required on an annual basis. Proof of citizenship and identity will be required, with a valid passport or certificates of naturalization and citizenship as primary documentary evidence. A state driver’s license works only if states had in place at the time the license was issued a requirement that applicants prove both identity and citizenship. Considering that some of the eldest Native Americans may not know where – if anywhere – a record of their birth exists and have neither the energy nor the means to actively pursue documentary evidence, unless additional time and resources are directed at discovery of some record, or additional time waivers are granted, it is quite possible that the overall health of tribal members will deteriorate. And this deterioration could just as easily affect those living in non-tribal urban areas as those actually residing on tribal lands.

At this moment, Native American health care is at a transition point. The United States Senate, on February 26, 2008, passed and sent to the House of Representatives the Indian Health Care Improvement Act (IHCIA) of 2007. Its whole purpose, following a 15 year gap since the last reauthorization expired, is to raise health standards among Native Americans by improving the availability and the quality of health care resources. With the House nearly finished with its version of the proposed legislation, it makes no sense to cut off for purely bureaucratic considerations the current level of health care that has survived the government’s inattention for a decade and a half.

Unfortunately, Congress goes into recess starting Friday, so nothing will transpire before they leave. House leaders ought to push forward the timetable for considering and voting out the IHCIA and sending it to President Bush to sign into law.


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