Archive for the 'Trahant' Category

Jun 18 2014

Presidents on the res

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

The Associated Press, MSNBC and other news media are sticking to the story that Obama is only the fourth president to visit a reservation. I say at least seven, more likely eight.

So one by one here goes the documentary evidence (for those who care).

President Chester Arthur’s visit to Wind River, Wyoming, 1883. Picture from Frank Jay Haynes collection, Smithsonian. The trip was on horse back and included a senator and the Secretary of War. (I love the umbrellas in the picture above.)

The second visit is President Warren Harding’s trip to Alaska in 1923. The first port of call was Metlakatla. (As Stephen Conn points out: Any presidential visit before the Alaska Native Claims Settlement Act would be a visit to Indian Country.)

Third. President Calvin Coolidge’s visit to South Dakota.

A trivia question: How many US Presidents have been photographed wearing headdresses? (It went badly for Coolidge.) Answer: At least one, Jimmy Carter.

Fourth. Franklin Roosevelt visited at least three reservations, only once speaking on Indian Affairs. He traveled to Quinault in Washington state, Blackfeet, Montana, and Cherokee, North Carolina. (He was also photographed with a chief in North Dakota.)

Here is a film from the Montana trip. (The meeting was in Glacier National Park, but he traveled from the town now called East Glacier.) Continue Reading »

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Apr 09 2014

Spending on waste or investment?

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

All you need to know about the November election is found in dueling documents: Paul Ryan’s budget and the House Democratic alternative. One is down, the other up. One “cuts wasteful spending,” while the other proposes investing in the future. Two radically different approaches to governing.

The Republican plan is in a hurry to balance the budget — slashing federal agency spending so that in a decade from now the budget will be balanced. These cuts would impact low-income populations, such as American Indians and Alaska Natives. Deeply.

And the Democrats’ budget is smart in the short-term — we do need investment now — but it fails to account for spending over a longer time frame. It leaves the answers to some big questions for a later date.

Then, truth be told, neither plan is designed for the long haul.

The United States (and much of the globe for that matter) is facing a demographic imbalance of a rising number of older people. Every day, for the next twenty years, some 10,000 people are turning 65. Think about adding that many people every day added to the rolls of Social Security and Medicare.

The good news is that Social Security is the easiest to fix, adjusting age and benefits, could make the plan solvent for the next generation.

But Medicare is wrapped in a bigger problem: the cost of health care in America.

A graphic from the Congressional Budget Office explains this well by breaking federal spending into four distinct categories: Social Security (growing); Interest on the debt (growing); all other federal spending (shrinking dramatically) and health care (growing faster than everything else). Or, as the CBO describes the problem, “Federal spending for the major health care programs and Social Security would increase to a total of 14 percent of GDP by 2038, twice the 7 percent average of the past 40 years.” Continue Reading »

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Mar 25 2014

Transparency and the ACA

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

The Affordable Care Act is a grand promise. Basically it’s a complicated insurance mechanism that’s designed to reduce the number of uninsured Americans, including those who rely on the Indian health system.

But one thing the ACA is not: Transparent.

This is a critical flaw because we are near another major deadline — March 31 — and some six months into the Act’s implementation and there is not one official scrap of information reporting how well Indian Country is being served. We don’t know how many folks across the country have signed up for Medicaid or how many have purchased insurance or how many individuals have policies that were purchased by tribes as sponsors.

Why does this matter? Because policy is being implemented on assumptions, not data. We don’t know what we don’t know.

This we do know: March 31 is an odd deadline. It’s the day when open enrollment ends for most Americans, including Native Americans who are not tribal members. But that deadline does not apply to American Indians and Alaska Natives who are tribal members. Then a monthly enrollment is possible. (I know, confusing, right?)

Native Americans still can receive a life-time exemption from the insurance mandate. Fill out a simple form and mail to get a certificate that could be included in your next tax return.

But we also know that the individual exemption is not enough. The Indian health system is underfunded and third-party billing — money from private insurance, Medicaid, Medicare, and other programs — is the only way funding will improve. Like it or not, Treaty or not, the Congress is not going to pay for Indian health through appropriations. The $6 billion budget for the Indian Health Service shows the agency collecting more than a billion dollars from Medicaid and only $90,307,000 from private insurance. So there is a lot of room for growth. Again, if folks sign up, the Affordable Care Act is a different course from appropriations; it’s a money stream that’s automatic.

We also know that Indian Country has some of the highest uninsured rates in the nation, roughly one in three people. So every new insured American Indian and Alaska Native adds resources to the Indian health system (and especially medical care that is purchased outside of Indian health facilities).

This week there is a last minute push to get people in Indian Country to sign up. On Monday there was a national Tribal Day of Action sponsored by the White House. And in Montana, the state’s Insurance Commissioner, Monica J. Lindeen, has been traveling to the state’s reservations and urban Indian centers to sell the plan.

But it’s hard to know how well those efforts are working. There are too many questions: How many people signed up early? What’s the goal? Where is the transparency?

Early Affordable Care Act numbers are found in Washington state. Ed Fox, who directs health services for Port Gamble S’Klallam Tribe of Washington, said the Washington Health Care Authority released preliminary figures to tribes for consultation. These are early numbers and will change, but they are an open important look in a state where the Affordable Care Act is working.

Some key findings: Washington probably ranks first in the nation in Medicaid “take-up” for the newly eligible. Some 6,000 or so of the newly insured Native Americans were enrolled by urban programs or tribes, and one-third with state worker assistance, and one-third a bit uncertain (possibly by someone with assistance or on their own). Washington also shows some 7,000 Medicaid re-certifications. Continue Reading »

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Mar 21 2014

Keys to the Senate: AK, SD, MT

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

Is it a foregone conclusion that the Senate will go Republican in November? That’s the talk coming from many strategists in both parties lately.

On Fox News Sunday, Karl Rove said it’s “highly likely” that the Republicans take power. He said seven seats could shift to the GOP control in November, Alaska, Arkansas, Louisiana, Montana, South Dakota, North Carolina and West Virginia. That’s one more than the Republicans need.

Former White House press secretary Robert Gibbs, on NBC’s Meet the Press, is saying something similar. “There’s a real, real danger that the Democrats could suffer big losses,” he said. (Current White House officials are saying — as they should — that Democrats will hang to the Senate.)

What’s pushing this speculation is a special election last week in Florida. It’s not that Democrats lost (it was a Republican seat, anyway). It’s that Democrats didn’t turn out. If that happens again in November, then Republicans win easily.

One of the states in play, Montana, is a good example of the problem.

There are a higher percentage of American Indian voters in Montana than in any other state except New Mexico, a registration that tops 64 percent (a slightly higher percentage than white voters in Montana). This made a difference two years ago when Sen. Jon Tester and State Superintendent of Public Instruction Denise Juneau both won re-election. But two years before that, those same voters disappeared. Conservative candidates won easily.

So is 2014 more like 2012 or 2010? Will Native American voters show up?

Montana is raising questions for other reasons, too. Senate candidate Steve Daines, a member of the House, has visited the state’s reservations and is making his case with tribal leaders.

There is also a difference of opinion in Montana over strategy. As Stephanie Woodard wrote in Indian Country Today Media Network, a voter access organization, Four Directions, blames Democrats for not expanding satellite balloting on the reservation.

The good news is that it’s early. There are months ahead to sort out a Native vote strategy and engage voters. But right now, Montana Senate race is looking like a pick up opportunity for the Republicans.

“If we lose the Senate,” Gibbs said, “turn out the lights. The party’s over.” The final two years of the Obama presidency will be one of defense, limiting the damage, instead of promoting any sort of agenda of growth.

For Indian Country that means more budgets cuts, GOP leadership for the Senate Select Committee on Indian Affairs, and more whittling away of the Affordable Care Act. Continue Reading »

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Mar 10 2014

Improving quality, cutting costs

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

The challenge in health care can be boiled down to two ideas: Improve the quality and cut the costs.

It’s a fact that the U.S. spends too much, both private and government money, on health care, nearly nearly 18 percent of all goods and services. The good news is that cost has been slowing, partly because of the economy, and most partly because the Affordable Care Act.

But this is just a first step. We have a long way to go. The reason is the country’s demographics: We have smaller population of young people, a huge baby boom generation, and people are living longer. Add this all up and the numbers are not sustainable by any metric. So math, not politics, ought to determine the route forward and that means looking for innovation to make health care less expensive. So when something comes along that does just that, you would think that it would be worth a celebration. But that’s not how change works.

As I have written before, the Alaska Native Tribal Health Consortium’s Dental Health Therapist Program is such a model. The Alaska program trains young people to practice mid-level dentistry, something that’s common around the world. This program expands access, improves quality, health, and is less expensive. It’s backed up by rigorous studies, that show mid-level providers offer “safe, competent and affordable care.”

So where is the celebration? Well, that will have to wait until the fight is over.

Washington state is considering legislation that would expand mid-level providers and the Washington State Dental Association is opposed saying that “midlevel providers will not make dental care more affordable, how dental residencies are a superior alternative, and how dentists in private practice are reimbursed 25 cents on the dollar for adult Medicaid patients.” Continue Reading »

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Mar 04 2014

Another reason Ryan is wrong

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

Paul Ryan is wrong. Way wrong.

On Monday the former Republican candidate for Vice President released a review of programs that attack the “war on poverty.” The House Budget Chairman said: “This 50th anniversary of the War on Poverty is an opportunity to review the record in full. And we should seize it.”

Ryan said the federal government has “measured compassion by how much we spend instead of how many people get out of poverty. We need to take a hard look at what the federal government is doing and ask, ‘Is this working?’ This report will help start the conversation. It shows that some programs work; others don’t. And for many of them, we just don’t know.”

The premise that underlies this report is Ryan, and Republicans, firmly held philosophy that government is not capable about solving problems. This is another push to shrink the federal government.

That said: A debate about the role of government is fair. It’s worth Republicans making their case that a smaller, stingy government would be effective. Then those candidates can take that message to the voters for affirmation (or more likely, rejection).

However when it comes to Indian health, Ryan’s War on Poverty review is factually incorrect. The Ryan report lumps the Indian Health Service in with other social programs. The history is described this way: “The IHS was officially established within the Department of Health and Human Services in 1955 (then the Department of Health, Education, and Welfare) as part of the Transfer Act. But the federal initiatives designed to increase access to health services for tribal members existed as far back as 1830.” Continue Reading »

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Feb 25 2014

Not honorable, but right in some ways

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

President Obama’s next budget, due to be released soon, will be good news for Indian Country.

The Washington Post describes the plan this way: “With the 2015 budget request, Obama will call for an end to the era of austerity that has dogged much of his presidency and to his efforts to find common ground with Republicans. Instead, the president will focus on pumping new cash into job training, early-childhood education and other programs aimed at bolstering the middle class, providing Democrats with a policy blueprint heading into the midterm elections.”

So does this mean austerity will end in Indian Country? Unfortunately, no. But this budget is a new approach — and it will have many implications in Indian Country.
Let me explain. It starts with this whole business of “austerity” or a government that shrinks itself and the economy.

The problem, essentially, in recent years is that Democrats have bought into the premise of austerity. There is this idea that a smaller government will somehow right the economy because the private sector will then create more jobs. Nonsense. There is far more evidence that when government invests in the economy there will be growth ahead.

The president’s budget adds an important twist to this debate by calling for sharp reductions in military spending. This will not be popular with Republicans (even though the U.S. spends $600 billion a year, more than the next ten nations combined on defense.)

There should be little debate among tribal governments about austerity. There is not much of a private sector in tribal nations to pick up the slack. So any significant reduction in government, whether it be welfare payments or support for law enforcement programs, reduces the number of jobs at home.

Spending for programs that directly benefit American Indians and Alaska Natives — such as the Bureau of Indian Affairs or the Indian Health Service — are from the portion of the budget that’s considered discretionary spending. Every dollar has to be appropriated by both houses of Congress and signed into law by the president. There has to be a “deal” to spend the money.

And discretionary spending is shrinking. Last year it totaled about $1.2 trillion and is projected to drop by $7 billion, less than 1 percent, in 2014.

The budgets that are growing are “mandatory” spending, money that’s automatic, such as Social Security, Medicare and Medicaid. Continue Reading »

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Feb 04 2014

Will you die waiting?

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

On a tribal bulletin board this week these chilling words were posted: “Due to budget issues, Contract Health Service will be on Priority One until further notice.”

Why are these words frightening? It means the underfunded local unit of the Indian Health Service is out of money on an important line item. It means that unless your illness is serious — threatening life or limb — you will have to wait.

Sometimes that wait can be deadly. And it’s wrong. It reflects a system that is out of balance and the consequences are life threatening to American Indians and Alaska Natives.

A couple of years ago, at a Senate hearing, a story was told about a heart attack patient who was left on a gurney with a note taped on her thigh that read: “If you admit this person, understand we’re out of contract health care money. Do it at your risk.”

The Affordable Care Act, or Obamacare, is supposed to eliminate this underfunding. The complicated mechanism is designed to increase the number of American Indians and Alaska Natives with basic insurance, Medicaid, tribal insurance, or a policy from a marketplace exchange, money that then goes into the Indian health system directly. The Affordable Care Act is designed to substantially increase third-party billing, a revenue stream that does not require appropriation from Congress. And, I should add, a revenue stream that could add a couple of billion dollars to the Indian health system. Full funding … in theory.

So what’s the problem? Why is there a bulletin board warning patients that’s there is not enough money?

The main reason is that critics of the Affordable Care Act are determined to make certain that this law is a wreck. Instead of figuring how to make it so, many so-called leaders are working overtime to tank every aspect of the act.

Just a couple of weeks ago, Wisconsin Republican Sen. Ron Johnson said it was time to “recognize reality” and “deal with the people that are currently covered under Obamacare.”

But that was then. Now three Republican senators, Richard Burr (N.C.), Tom Coburn, (Okla.), and Orrin Hatch (Utah), are launching a campaign to start the debate all over, promoting a “replacement” plan for Obamacare. That plan would make it even more difficult to fund the Indian health system. “Under our proposal, restrictions that limit the ability for veterans, service members, and individuals receiving care through the Indian Health Service would be removed in order to ensure that these individuals also have the ability to benefit from health savings accounts in managing their health care needs and expenses,” according to the plan. Continue Reading »

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Jan 30 2014

A part of the state of the union

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

The thing I like about state of unions — the national kind, the NCAI kind, and the tribal kind — is that it’s a to do list. Leaders see this is a list of “action items” while I see this as a list of fascinating issues that are worth exploring in future columns.

I want to start with an idea raised by President Barack Obama in his State of the Union message: “Let’s make this a year of action. That’s what most Americans want – for all of us in this chamber to focus on their lives, their hopes, their aspirations.”

What would a “year of action” look like in Indian Country? And, more important, how do we get there?

National Congress of American Indians President Brian Cladoosby began this year’s State of Indian Nations by talking about so many of the success stories from Indian Country. “Tribal leaders and advocates have never been more optimistic about the future of native people,” he said. But that sense of possibility is “threatened by the federal government’s ability to deliver its promises.”

President Cladoosby released NCAI’s budget request for the coming fiscal year. That document calls for funding treaty obligations with the “fundamental goal” of parity for Indian Country with “similarly situated governments.” As a moral case, and cause, this is exactly right. This is an aspirational document, as it should be.

But in a year of action there needs to be another route forward. This Congress is incapable of honoring treaties. Even in a more friendly era, members of Congress proudly called Indian health a “treaty right” only to appropriate less than what was required. This year’s federal budget essentially is flat (which means less program dollars because Indian Country’s population is growing). NCAI puts it this way: “However, the trend in funding for Indian Affairs in the Department of the Interior does not reflect Indian self-determination as a priority in the federal budget.”

But it’s not the Interior Department. It’s all of government and especially the Congress. Continue Reading »

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Jan 21 2014

Year of the native voter?

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

Could this be the year of the Native voter?

That’s a tall order for a population that’s less than one percent of the country. But American Indians were key contributors to winning coalitions in Wisconsin, North Dakota and Montana two years ago and there is the potential to do even better this time around.

Three things have to happen first, though. There must be candidates who are inspirational. Next, there must be organization and money. And, third, American Indians and Alaska Natives have to actually vote.

Step one is on target. There are already more high profile candidates for office in 2014 than in any election I can recall. For example, former Colville tribal chairman Joe Pakootas is running against Rep. Cathy McMorris-Rodgers in Washington state. This is a tough race, but Pakootas has a great election narrative: How he turned around a money-losing tribal enterprise and made it profitable, creating jobs along the way.

The candidacy of Byron Mallott for governor of Alaska has to be at the top of any list. Mallott has the ideal resume. He’s a member of the Yakutat Tlingit Tribe, and a clan leader of the Kwaashk’i Kwáan of the Raven people. He has worked in state government and as the chief executive of Sealaska corporation. Mallott was mayor of two towns including Juneau, the state capital.

Mallott’s path to the Democratic Party nomination is clear so he will face incumbent, Republican Gov. Sean Parnell.

Parnell, it seems, has gone out of his way to be on the other side of Alaska Native issues. The governor rejected Medicaid expansion, saying the federal Indian Health Service is good enough health care access for Alaska Natives. This is absurd. There is not enough money in the Indian health system. But at the same time he tells the federal government to cover health care for Alaska Natives, the governor demands sovereignty over subsistence hunting and fishing asking for a Supreme Court review of the Katie John case. Continue Reading »

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Jan 14 2014

Congress and the budget of meh

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

The adjective of the day is “modest.” That’s the standard phrase to describe the $1.012 trillion spending bill for a federal fiscal year that has less than nine months left. The bill gives modest relief from the sequester. There are tiny (I can’t bring myself to say “modest” even in jest) increases in some federal programs, including the Indian Health Service and the Bureau of Indian Affairs, and it puts off the fight over the size and nature of government until another day.

This is the Budget of Meh. It better reflects a broken governance structure than it does true spending priorities. Neither the right, those who want to shrink government, nor those of us who want to the government to invest in key program areas can claim victory. Meh.

This budget reflects a continuing trend of austerity. The federal government is shrinking. Sort of. And austerity rules.

House Appropriations Committee Chairman Hal Rogers, R-Kentucky, took credit for this idea in his news release about the compromise spending plan. “The Omnibus will fulfill the basic duty of Congress; it provides funding for every aspect of the federal government, from our national defense, to our transportation systems, to the education of our kids,” Rogers said. “The bill reflects careful decisions to realign the nation’s funding priorities and target precious tax dollars to important programs where they are needed the most. At the same time, the legislation will continue the downward trend in federal spending to put our nation on a sustainable fiscal path.”

But Rogers’ line of thinking is misleading. This huge, 1,500-plus page spending bill, only covers federal dollars that are appropriated, about one-third of the budget. This is the budget that’s shrinking, while two-thirds of the budget continues untouched on an automatic pilot, including Social Security, Medicare, Medicaid, Children’s Health Insurance and, I hope, money that is pumped into the Indian health system through the Affordable Care Act.

So for Indian Country the appropriations process is broken beyond repair; business as usual is no more. The federal programs that have served Indian Country well are essentially continuing to shrink. The Omnibus budget, for example, shows an increase of $18 million for the Bureau of Indian Affairs. Eighteen million! Wow. In percentage terms that’s less than one percent. The IHS increase is under 2 percent. Continue Reading »

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Jan 07 2014

A look ahead in Indian country

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

It’s a new year — and a new story. There is nothing more important to political discourse than a good story. It shapes our thinking, sets the rules for the debate, and, sometimes, warps reality. Stories matter. We humans think in terms of story. We dream, tell, and remember stories. We live stories.

So what’s Indian Country’s “story” for 2014?

Before I answer that question, let’s look back at recent narratives.

The first story goes like this: Congress broke promises made to Indian Country by cutting federal budgets beyond all reason, especially through the sequester. This made reservation life far more difficult, removing children from Head Start, scaling back educational opportunities, severe funding for healthcare delivery, and basic government infrastructure.

The New York Times, in a July editorial, captured this storyline. “It’s an old American story: malign policies hatched in Washington leading to pain and death in Indian country. It was true in the 19th century. It is true now, at a time when Congress, heedless of its solemn treaty obligations to Indian tribes, is allowing the across-the-board budget cuts known as the sequester to threaten the health, safety and education of Indians across the nation.”

This is an important story to know. And to tell. But it’s also important to know that the story already has its ending. There are only two ways to change what happens next, vote out Congress or limit the damage. (More about both of those scenarios in future columns.) The second alternative is remote, but possible in 2014, with measures such as Montana Senator Jon Tester’s bill to fund Indian health programs a year in advance.

Another story told this year is about changing the name of the Washington NFL team. This story is important because it’s a success story (I know, the issue isn’t resolved. Yet. But it’s inevitable. The question is how long the team owner will fight on, not the outcome.) Forget the merits of the mascot debate for a minute and just think about the storytelling aspect.

This story is all about the long view. Suzan Shown Harjo, Raymond D. Apodaca, Vine Deloria, Jr.; Norbert S. Hill, Jr.; Mateo Romero; William A. Means; and Manley A. Begay, pressed a case calling for the cancellation of the team’s trademark protections. It’s step-by-step litigation that’s built a through record about “pejorative, derogatory, denigrating, offensive, scandalous, contemptuous, disreputable, disparaging and racist designation for a Native American person.”

The velocity of change picked up in February when the National Museum of the American Indian held a public symposium on the mascot issue. This was a story told in the heart of Washington, challenging and burying status quo.

So much so that Harjo and her allies have already won the tides of history and public opinion. The NFL doesn’t see it that way. Yet. But it will will. And if not, the litigation continues in a new form, the case now known as Blackhorse et al v. Pro-Football Inc. This is a story that’s ready for an ending.

A third story — another one about success — is the signing into law of reauthorization of the Violence Against Women Act, including provisions that recognize tribal jurisdiction. This law is a tribute to the power of story. It probably would not have become law until Deborah Parker, Vice Chairman of the Tulalip Tribes, told her story to Sen. Patty Murray and then in a Senate news conference. Parker’s narrative changed the politics. The law’s supporters built a successful coalition that trumped the politics of the ordinary, especially in the House of the Representatives. This Violence Against Women Act story, though, needs an ending. It’s not enough to pass a law, there has to accounts about how this law has really made a difference in the lives of women are abused. Continue Reading »

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Dec 30 2013

The Forrest Gerard story

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

What is “The Canon of Indian Country?”

Those stories that are recited in schools, the ones most young people know by heart, tales of valor, excellence and an optimistic future.

We do have great modern stories to tell.

How leaders like Joe Garry or Lucy Covington out maneuvered Congress and put an end to the nonsense called termination. Or how Taos leaders patiently pressed the United States for the return of the sacred Blue Lake, even though that effort that took nearly seven decades. Or how a summer program in New Mexico helped create an entire generation of American Indian and Alaska Native lawyers.

But there is no canon. So important stories drift about in individual memory, forgotten far too easily, instead of being told again and again.

The story of Forrest Joseph Gerard is one that ought to be required in any Indian Country canon. He died on December 28, 2013, in Albuquerque.

Forrest Gerard was born on Montana’s Blackfeet Reservation on January 15, 1925, on a ranch near the Middle Fork of the Milk River. He told me that his “childhood I had there would have been the envy of any young boy in the United States. We had a horse of our own. We could walk maybe 15 or 20 yards have some of the best trout fishing in northern Montana. We had loving parents. We had love, support and discipline. And this was my universe, this was a world I knew.”

That world he knew changed many times in his early life. During the Great Depression his family moved into the “city” of Browning so his father could take a job. After his high school graduation, Gerard was eager to join the military and enter World War II. He was only 19 on his first bombing mission on a B-24 with the 15th Air Force. “We were forced to face life and death, bravery and fear at a relatively young age. That instilled a little bit of maturity into us that we might not under normal circumstances,” Gerard recalled. The military also opened up access to the G.I. Bill of Rights and a college education, the first in his family to have that opportunity. Continue Reading »

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Dec 26 2013

Indian health money left behind

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

Monday was a key deadline for the Affordable Care Act. In order to begin insurance coverage on January 1, 2014, people were supposed to sign up by December 23, 2013, for that shiny new policy.

(On Monday the White House announced the deadline is extended a stay. That’s a good thing for people trying to navigate the web site at the last minute.)

How many American Indians and Alaska Natives signed up for this new program? Who knows? But you’d think that something this important would have so much information posted about that it would almost be annoying. There should be posters, flyers, signup fairs, reminders and banners. This should be a big deal.

Instead this deadline whizzed by, hardly making a sound in Indian Country.

So this is why the deadline, and health insurance, matters.

From this point forward every American Indian and Alaska Native who signs up for some form of insurance, through a tribe or an employer, via Medicaid, or through these new Marketplace Exchanges, adds real money to the Indian health system.

How much funding? Healthcare reform expert Ed Fox estimates the total could exceed $2 billion. But what makes that $2 billion even more important is that it does not need to be appropriated by Congress. Continue Reading »

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Dec 06 2013

Health reform ahead

Published by under Trahant

trahant MARK
TRAHANT

 
Austerity

The healthcare.gov web site is working. I spent some time on it this weekend and it was easy to navigate, pages popped up when they should, and I quickly found answers.

All of this is good news because it will make it easier for folks to fill out the forms and see what’s possible under the Affordable Care Act. If you want insurance to begin on January 1, 2014, then you need to fill these forms out this month. The deadline is December 23.

But for American Indians and Alaska Natives this process is both confusing and damning. It’s confusing because it’s a form that requires financial information, a lot like a tax return, so it means rounding up some documents. The damning part? I’ll get to that shortly. First let’s explore the healthcare.gov process.

For American Indians and Alaska Natives: The most important form is “Appendix B.” This is the paperwork that secures a lifetime exemption from the insurance mandate. Lifetime is a pretty good deal. So paperwork or not, this is worth doing this month (or you can also file this with your tax returns in April).

There is help to fill out these forms. Go to the Indian Health Service or a local urban or tribal clinic. Find someone there who has been trained. You should get answers, because, as IHS acting director Yvette Roubideaux wrote recently, “I don’t know is not an acceptable answer.”

One of the best things I read this weekend was an item in Montana’s Char-Koosta News with a schedule of community meetings on the Affordable Care Act. Yes! This should be happening across Indian Country.

There needs to be information, not just cheerleading, about what this law means and how it might change the Indian health system. (This is the main reason for my five-part video series with Vision Maker Media .) The law will shake up the Indian health system dramatically, opening up new funding sources, as well as presenting new challenges.

The problem is that so much of the discourse has been cast in absolute terms. Democrats need to recognize that this law, like the web site, is not perfect. It’s just one step — and a complicated one at that. And Republicans would better serve the country if they would stop crying repeal and look for constructive additions or subtractions. Continue Reading »

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Next »

 


Two bulls fire near Bend, and defensible space.

 

JOURNEY WEST

by Stephen Hartgen
The personal story of the well-known editor, publisher and state legislator's travel west from Maine to Idaho. A well-written account for anyone interested in Idaho, journalism or politics.
JOURNEY WEST: A memoir of journalism and politics, by Stephen Hartgen; Ridenbaugh Press, Carlton, Oregon. $15.95, here or at Amazon.com (softcover)

 

 

NEW EDITIONS is the story of the Northwest's 226 general-circulation newspapers and where your newspaper is headed.
New Editions: The Northwest's Newspapers as They Were, Are and Will Be. Steve Bagwell and Randy Stapilus; Ridenbaugh Press, Carlton, Oregon. 324 pages. Softcover. (e-book ahead). $16.95.
See the NEW EDITIONS page.

How many copies?

 
THE OREGON POLITICAL
FIELD GUIDE 2014

The Field Guide is the reference for the year on Oregon politics - the people, the districts, the votes, the issues. Compiled by a long-time Northwest political writer and a Salem Statesman-Journal political reporter.
OREGON POLITICAL FIELD GUIDE 2014, by Randy Stapilus and Hannah Hoffman; Ridenbaugh Press, Carlton, Oregon. $15.95, available right here or through Amazon.com (softcover)

 
 
THE IDAHO POLITICAL
FIELD GUIDE 2014

by Randy Stapilus and Marty Trillhaase is the reference for the year on Idaho Politics - the people, the districts, the votes, the issues. Written by two of Idaho's most veteran politcal observers.
IDAHO POLITICAL FIELD GUIDE 2014, by Randy Stapilus and Marty Trillhaase; Ridenbaugh Press, Carlton, Oregon. $15.95, available right here or through Amazon.com (softcover)

 
 
without compromise
WITHOUT COMPROMISE is the story of the Idaho State Police, from barely-functioning motor vehicles and hardly-there roads to computer and biotechnology. Kelly Kast has spent years researching the history and interviewing scores of current and former state police, and has emerged with a detailed and engrossing story of Idaho.
WITHOUT COMPROMISE page.

 

Diamondfield
How many copies?
The Old West saw few murder trials more spectacular or misunderstood than of "Diamondfield" Jack Davis. After years of brushes with the noose, Davis was pardoned - though many continued to believe him guilty. Max Black has spent years researching the Diamondfield saga and found startling new evidence never before uncovered - including the weapon and one of the bullets involved in the crime, and important documents - and now sets out the definitive story. Here too is Black's story - how he found key elements, presumed lost forever, of a fabulous Old West story.
See the DIAMONDFIELD page for more.
 

Medimont Reflections Chris Carlson's Medimont Reflections is a followup on his biography of former Idaho Governor Cecil Andrus. This one expands the view, bringing in Carlson's take on Idaho politics, the Northwest energy planning council, environmental issues and much more. The Idaho Statesman: "a pull-back-the-curtain account of his 40 years as a player in public life in Idaho." Available here: $15.95 plus shipping.
See the Medimont Reflections page  
 
Idaho 100 NOW IN KINDLE
 
Idaho 100, about the 100 most influential people ever in Idaho, by Randy Stapilus and Martin Peterson is now available. This is the book about to become the talk of the state - who really made Idaho the way it is? NOW AN E-BOOK AVAILABLE THROUGH KINDLE for just $2.99. Or, only $15.95 plus shipping.
 

Idaho 100 by Randy Stapilus and Martin Peterson. Order the Kindle at Amazon.com. For the print edition, order here or at Amazon.


 

    Top-Story-graphic-300x200_topstory8
    Monday mornings on KLIX-AM

    watergates

    ORDER IT HERE or on Amazon.com

    More about this book by Randy Stapilus

    Water rights and water wars: They’re not just a western movie any more. The Water Gates reviews water supplies, uses and rights to use water in all 50 states.242 pages, available from Ridenbaugh Press, $15.95

    intermediary

    ORDER IT HERE or on Amazon.com

    More about this book by Lin Tull Cannell

    At a time when Americans were only exploring what are now western states, William Craig tried to broker peace between native Nez Perces and newcomers from the East. 15 years in the making, this is one of the most dramatic stories of early Northwest history. 242 pages, available from Ridenbaugh Press, $15.95

    Upstream

    ORDER HERE or Amazon.com

    The Snake River Basin Adjudication is one of the largest water adjudications the United States has ever seen, and it may be the most successful. Here's how it happened, from the pages of the SRBA Digest, for 16 years the independent source.

    Paradox Politics

    ORDER HERE or Amazon.com

    After 21 years, a 2nd edition. If you're interested in Idaho politics and never read the original, now's the time. If you've read the original, here's view from now.


    Governing Idaho:
    Politics, People and Power

    by James Weatherby
    and Randy Stapilus
    Caxton Press
    order here

    Outlaw Tales
    of Idaho

    by Randy Stapilus
    Globe-Pequot Press
    order here

    It Happened in Idaho
    by Randy Stapilus
    Globe-Pequot Press
    order here

    Camping Idaho
    by Randy Stapilus
    Globe-Pequot Press
    order here