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More stories than spread sheets

trahant MARK
TRAHANT

 
Austerity

Modern budgets in the federal government are more stories than spread sheets.

Consider the three competing budgets for 2014. The House budget is stark. There are no new taxes and spending drop below even the sequester levels. The Senate sets out a very different course. That budget plan increases taxes, mostly on the White House, and restores spending to many parts of the budget.

Today’s White House plan melds the House and Senate into a compromise plan. That is, if compromise is even possible in today’s political environment. Remember that no single plan, not the House, not the Senate, and certainly not the president’s, will be enacted into law without lots of changes, debates, and compromises. This is only the beginning of the process where every line is written in pencil. (The Washington Post has a great graphic that shows how rare it is for a president’s budget to actually get enacted.)

But this is a smart budget. It’s might even work because it’s neither the House nor the Senate approach.

“The budget also incorporates the president’s compromise offer to House Speaker Boehner to achieve another $1.8 trillion in deficit reduction in a balanced way,” the White House says. “When combined with the deficit reduction already achieved, this will allow us to exceed the goal of $4 trillion in deficit reduction, while growing the economy and strengthening the middle class. By including this compromise proposal in the budget, the president is demonstrating his willingness to make tough choices and his seriousness about finding common ground to further reduce the deficit.”

There is a lot to like in the president’s budget because it invests in the areas of government that require more money, mainly education. If you pull back and look at the big picture, the federal government’s primary challenge is demographic -- an aging workforce that’s ready to retire -- so the best answer is to invest heavily in education, so that young people have the skills to earn as much income as possible. (Instead of what we’re doing now: Loading up this generation with student debt.)

The budget: “Improves college affordability and value with a continued commitment to Pell Grants; budget-neutral student loan reforms that will make interest rates more market-based; a $1 billion Race-to-the-Top fund to support competitive grants to States that drive higher education reform, while doing more to contain tuition; a $260 million First in the World fund to spur cutting-edge innovations that decrease college costs and boost graduation rates; and reforms to Federal campus-based aid to reward colleges that set responsible tuition policy, provide a high-quality education and better serve students with financial need.” (more…)

How to stop the sequester

trahant MARK
TRAHANT

 
Austerity

A couple of weeks ago I was on Capitol Hill. In between meetings, I sat in the sun and watched tourists come and go. I also saw the First Amendment in action -- the right of the people to petition the government for a redress of grievances (or lobbying as it’s known these days) -- as tribal leaders, community representatives and lobbyists rushed past the visitors on their way to their next appointment.

This is the tried-and-true formula for reversing such things as the sequester. Someone from the home district flies to Washington and then makes the case to their member of Congress for a different course. It’s how the process is supposed to work.

It’s even possible that this route will work again. Sometime this summer when Congress enacts a new debt ceiling or next year’s budget there might be enough support to fix the worst problems of the sequester.

Then again it’s important to remember that the sequester is just one element in the broader austerity push. Austerity is a trend in governance, federal, state, and even tribal, and resources will continue to shrink. The only way to slow, let alone reverse, this trend is to substitute the players on Capitol Hill. In other words: Win the next election.

What if Democrats ran the House of Representatives and the Senate during Obama’s last two years in office? The budgets would be far superior for Indian Country (to be fair: there is support from Republicans for Indian Health Service and Bureau of Indian Affairs money, the difference would be that Democrats support that revenue stream plus money from other federal program sources.) (more…)

Changes ahead on Indian health

trahant MARK
TRAHANT

 
Austerity

Three years ago, on March 23, 2010, President Barack Obama signed into law the Affordable Care Act. The bill also included the permanent authorization of the Indian Health Care Improvement Act.

As I wrote at the time: “When Medicare and Medicaid passed Congress in 1965 and were signed into law there was no consideration – none – of how those bills impacted Indian Country. It was as if the Indian Health Service, then all federal employees, was off the books, a forgotten instrument. In fact there wasn’t even a plan that allowed IHS to tap into Medicare or Medicaid dollars. That had to wait for the Indian Health Care Improvement Act of 1976.

That is not the case with President Obama’s health care reform. Indian Country is included throughout the document in large and small measures designed to improve the health of Native people.”

Indeed, three years later, only a year before many of the most important provisions of the law begin, it’s hard to understate what this law means to the Indian health system.

Consider the money. The Indian Health Service is funded largely by appropriations. In recent years this has worked well with bipartisan support for increased funding. Since 2008 there has been a 29 percent increase in IHS funding.

But that is unlikely to continue. The appropriations process itself is, well, I’ll use the technical term here, a total wreck. So getting a logical appropriation will be less and less likely.

But the Affordable Care Act opens up revenue streams that are not appropriations, money that is, essentially, automatic. If a patient qualifies, then the money is there. This happens two ways. First, many more people will be eligible for Medicaid funding and second there will be new insurance exchanges with plans that could be purchased by both individuals and tribes, mostly, as employers. (more…)

More money, better health?

trahant MARK
TRAHANT

 
Austerity

Idaho’s Rep. Mike Simpson, a Republican, asked a critical question Tuesday. It’s one rarely asked, let alone, answered. The question: Does more government money work?

Specifically, Simpson, the chairman of the House Interior Appropriations Subcommittee on Interior, Environment, and Related Agencies, was asking if recent increased funding for the Indian Health Service has made a difference.

Dr. Yvette Roubideaux, director of the IHS, went through the numbers at an oversight hearing. IHS appropriations have increased 29 percent since 2008 which, she said, is “making a substantial difference in the quantity and quality of healthcare we were able to provide to American Indians and Alaska Natives.”

For example: Contract Health Service dollars, money spent to purchase medical services outside of the Indian health system, has been increased by 46 percent since 2008. “Four years ago, most programs were funding only Medical Priority 1, or ‘life or limb’ referrals. Now, Dr. Roubideaux reported, “the increased CHS funding means that almost half (29 out of 66) of Federal CHS programs are now funding referrals beyond Medical Priority 1.”

That means that there is now money, at least some money, for preventative services such as mammograms and colonoscopies. “The increased CHS money also means that the IHS Catastrophic Health Emergency Fund, which used to run out of funding for high cost cases in June, now is able to fund cases through August,” Dr. Roubideaux said.

Simpson said: “You can get sick now up to August?” To which Dr. Roubideaux replied, that the phrase, “Don’t get sick after June,” has been incredibly effective describing the problem of what it means for a health care delivery system to run out of money.

Clearly more money in the contract health care (soon to be labeled in the next budget as “purchased and preferred care”) program is making a difference and most likely saving lives. But what about in other program areas? There the data is convincing as well. The Improving Patient Care program, a team based approach to care, has increased the number of sites to a total of 127 (adding 89). This has resulted in both quantity (empanelling 261,180 active patients in a primary care team up from 85,079) and quality (IPC sites show patient satisfaction increasing from 55 percent in April 2011 to 72 percent currently.)

IHS has provided more women mammograms, up from the low to mid-40 percent range to more than 50 percent.

No one thinks that there is enough money in the Indian health system. But in this one subcommittee there is bipartisan agreement that more government spending does indeed work and that the Indian Health Service could use more. This is dangerous talk in DC, the very words that strike fear, government spending is effective. (more…)

Austerity’s limits: Will Congress notice?

trahant MARK
TRAHANT

 
Austerity

Three words to think about as we near the next budget fight on Capitol Hill: Austerity has limits.

As I have written often, I view the austerity trend as a global one, not a national debate. That’s important to remember because other countries are further along in their austerity implementation, policies that should give the U.S. Congress real examples of what works and what’s a disaster.

Italy’s soon-to-be former prime minister makes that case. “Public support for the reforms, and worse, for the European Union, is dramatically declining, following a trend which is also visible in many other countries across the union,” Mario Monti said in The Guardian newspaper. “To revive growth and fight long-term and youth unemployment would be the best message to counter the mounting wave of populism and disaffection with the European Union, showing that Europe is listening to people's concerns.”

Anti-austerity efforts are gaining strength in the United Kingdom and Spain.

But the dumbest austerity action came last week in one of Europe’s tiniest countries, Cyprus.

As part of a bailout deal, that country’s government agreed to a tax on the savings accounts of its citizens ranging from 6.75 percent to 9 percent. The president of Cyprus said Sunday night it was either the tax or his country would have to leave the European Union and face national bankruptcy. “I chose the least painful option, and I bear the political cost for this, in order to limit as much as possible the consequences for the economy and for our fellow Cypriots,” Anastasiades said in The Global Post.

So the people of Cyprus rejected that policy and began withdrawing money as fast as they could before any such tax could be imposed; a classic run on the banks. (more…)

A pattern of caves?

trahant MARK
TRAHANT

 
Austerity

This is not a headline that any political party wants to read: “House GOP Caves: Violence Against Women Act Impasse Finally Broken.” The shape of a new deal is simple, according to Talking Points Memo. “The Rules Committee instead sent the House GOP’s version of the Violence Against Women Act to the floor with a key caveat: if that legislation fails, then the Senate-passed version will get an up-or-down vote.”

In other words, the majority of the House, a combination of reasonable Republicans and Democrats will have the final say. Thus the Senate bill, including expanded jurisdiction for tribal governments, is much more likely to pass. As I have written before, the Violence Against Women Act makes sense in this era of austerity because it reflects an efficient tool for Domestic Violence prosecution. But let’s not get ahead of ourselves, the House still must vote for the Senate bill.

But the bigger picture is that conservatives are losing across the board right now.

Look at this week’s action list:

Conservative governors across the United States are buying into the Medicaid expansion under the Affordable Care act. Most recently Florida Gov. Rick Scott and Gov. Chris Christie signed their states up for the program.

In the Senate, conservatives could not hold their own members on a filibuster against Chuck Hagel. He’s now the Secretary of Defense.

And, yesterday, a congressional candidate in Illinois won her primary (essentially, the election in a district that is heavily Democratic) running against the National Rifle Association.

And two days before the sequester begins, there is growing evidence that the American public is siding with the president. A Washington Post-ABC news poll found that “67 percent of those tested disapproving of the way Republicans in Congress are handling federal spending.”

So how are Republicans responding? Will they fold on the sequester sooner or later?

The conservative blog Red State says “conservatives, not liberals” are now the problem. It calls for Republicans to oppose their own leadership more often and block bills by voting against their leader’s proposed rules. Erick Erickson writes: “So why do House conservatives support the rules on bad bills? Because leadership tells them to. And they fear that they will get punished for crossing leadership. But our allies need to be made aware that saving our country strongly outweighs preserving allegiance to leadership hacks. And we will be there to support them if they choose to fight.” (more…)

And no course is set

trahant MARK
TRAHANT

 
Austerity

The sequester begins in four days and Congress is set on a do nothing course.

Not that anyone is happy about it.

The White House over the weekend released a state-by-state list of impacts. (I wish a similar sheet had been released for the impact on tribal governments.) For example: “Alaska would lose about $1.8 million environmental funding to ensure clean water and air quality, as well as prevent pollution from pesticides and hazardous waste,” the White House said. Another program that will lose money there is the Nutrition Assistance for Seniors, some $184,000.

Elderly lunches are big in Indian Country, both on reservations, across Alaska and in urban Indian centers. The White House says that sequester will mean 4 million fewer meals this year. “These meals contribute to the overall health and well-being of participating seniors, including those with chronic illnesses that are affected by diet, such as diabetes and heart
disease, and frail seniors who are homebound,” the White House said. “The meals can account for 50 percent or more of daily food for the majority of participants.”

All week we will be hearing about the impact of these cuts on real programs and real people. Especially federal employees and contractors whose family budgets will be cut by furloughs and other means.

But what about the politics?

President Barack Obama says these cuts will be required by law and the impacts are real. He has his own plan to avoid them.

Republicans, generally, are continuing to blame President Barack Obama for the sequester, saying it was his idea. But that’s a bit complicated because Republicans then voted for the plan. And, more important, both sides said that sequester would never happen. But the Congress is so broken that there is no hope of a deal at this point. Neither Speaker of the House John Boehner nor Senate Majority Leader Harry Reid have the votes to enact a budget or a real relief to the sequester act that nearly everyone calls a stupid way to govern. (more…)

More challenges in Indian country

trahant MARK
TRAHANT

 
Austerity

Later this morning President Barack Obama will make yet another pitch, calling on Congress to stop the sequester with a balanced approach. Of course nothing will happen today. Congress is not even in town. Congress being Congress took the week before the sequester off.

But before I get back to writing about the politics of the sequester, and, more important, the longer impact of austerity on Native American programs, I wanted to add my view of two recent books: “Iveska,” by Charles Trimble, and “This Indian Country,” by Frederick E. Hoxie. I read both of these books through the filter of Indian Country’s current challenges.

A little background. A couple of years ago I wrote, “The Last Great Battle of the Indian Wars.” In that book I made the case that the self-determination era was different because it ended the debate about whether tribal governments should even exist in this century. (It’s about Forrest Gerard and how Sen. Henry Jackson went from championing termination to sponsoring the self-determination act in Congress.)

My title was too optimistic and wrong; there are many battles left to fight.

Indian Country has had a run of some forty years where Democrats and Republicans have pledged their support to the idea that tribal governments are best equipped to solve the problems of Indian Country. But over the last couple of years that has started to change. There is growing number of politicians, who, in the name of austerity, are proposing radical ideas that are essentially a reprise of the termination policy of the 1950s. Want proof? Look no further than Sen. Rand Paul’s plan to balance the budget in five years. The Kentucky Republican’s proposes economic termination.

That’s why Trimble’s book is worth reading now. The former executive director of the National Congress of American Indians looks back at several challenges that Indian Country faced during this modern era, including termination and the 1970s backlash. I am always inspired after reading accounts of the Colville Tribe’s rejection of termination and the leadership of Lucy Covington. Trimble was recruited by Covington to start a newspaper, “Our Heritage,” as part of that effort.

A few years later, in the 95th Congress, Trimble writes about another challenge to Indian Country, the backlash. There were fourteen pieces of legislation that would have reversed tribal hunting and fishing rights, court victories, terminating federal-tribal relations, and abrogating Indian treaties.

The way forward was for a grand coalition, an action coalition, that worked together to limit and then reverse the dangerous ideas that were coming from Congress. “NCAI pulled Indian Country together and the backlash was defeated, including every piece of anti-Indian legislation that came out of the movement,” Trimble writes. “It was interesting to note that the principal sponsors of those pieces of legislation were also defeated in their bids for re-election.” (more…)

‘A moment of real possibility’

trahant MARK
TRAHANT

 
Austerity

National Congress of American Indians President Jefferson Keel began his annual report, State of Indian Nations, with a simple exclamation. “Indian Country is strong!” That statement, he added, is something he hasn’t always been able to say. He then described this as “a moment of real possibility.”

And why not? There is a long list of tribal success stories. Tribes across the country are economic engines creating thousands of jobs. The phrase, “one of the largest employers in the county,” is one that’s repeated often and with good reason. (I see this type of success out my own window, looking at the Shoshone-Bannock Hotel and Event Center on the horizon.)

What’s more, Indian Country has something that the rest of the country is missing: Young people. There are now more people older than 65 in the U.S than people between 18 and 24. However 42 percent of Indian Country is under 25 years old, as Keel noted today. This is a huge advantage, a moment of real possibility.

Except. This advantage is coming at the same time as this massive wave called austerity is hitting.

A couple of things to think about. First, Austerity is not just about the sequester or the current budget; it’s a long-term trend that will rip apart many of the platforms that have been built and taken for granted by Indian Country over the past forty years.

Austerity has the potential to wipe out any moment of possibility because it attacks the very group of people we need the most, young people. This shift actually started years ago when we allowed young people to be buried in debt in order to attend college. Soon it will impact Head Start, elementary and secondary schools, virtually every program we need to educate young people. So, at least in my way of thinking, this education deficit is the most serious debt problem in the United States.

The most immediate threat - but just the first - from this austerity wave will begin in a few days with the sequester, or across the board, federal budget cuts. Already many in Congress are already calling these cuts “inevitable” at least for the month of March. (There is a hope that the Continuing Resolution, the current budget, will fix the sequester. That CR expires on March 27 and must be re-enacted or there will be a federal government shutdown.) (more…)

A North Star toward growth

trahant MARK
TRAHANT

 
Austerity

Let’s jump right to the big questions: Did President Barack Obama’s State of the Union do anything to resolve the deep differences in philosophy and policy on Capitol Hill? Was there any common ground? Did he lay the groundwork to find enough votes to stop the sequester, or better, to find a real budget solution?

I don’t think so. What’s more: I don’t think there is agreement on the nature of the problem, let alone any of the solutions.

As far as speeches go, it was a good one. The president pitched his case for where the country should go in terms of both philosophy and policy. My favorite line was this one: “A growing economy that creates good, middle-class jobs – that must be the North Star that guides our efforts. Every day, we should ask ourselves three questions as a nation: How do we attract more jobs to our shores? How do we equip our people with the skills needed to do those jobs? And how do we make sure that hard work leads to a decent living?”

This line should be inspirational: “A growing economy ... must be the North Star that guides our efforts.” Yet it represents the deep divisions in U.S. politics because a growing economy cannot occur in an era of austerity.

A great example of this divide surfaced when Florida Sen. Marco Rubio gave the Republican response. “Unfortunately, our economy actually shrank during the last three months of 2012,” Rubio said. “But if we can get the economy to grow at just 4 percent a year, it would create millions of middle class jobs. And it could reduce our deficits by almost $4 trillion dollars over the next decade.”

But if you dig into the numbers, there is no evidence for that kind of statement. Economists for the Bipartisan Policy Center say the sequester will cost over a million jobs in 2013 and 2104. The total economy will likely drop from north of 4 percent GDP -- the number Rubio used -- to under 2 percent.

Federal Reserve Chairman Ben Bernanke says it will be worse. He says a sequester will send the country into a new recession.

But even the nature of the sequester is a dividing line. The president put it this way: “In 2011, Congress passed a law saying that if both parties couldn’t agree on a plan to reach our deficit goal, about a trillion dollars’ worth of budget cuts would automatically go into effect this year. These sudden, harsh, arbitrary cuts would jeopardize our military readiness. They’d devastate priorities like education, and energy, and medical research. They would certainly slow our recovery, and cost us hundreds of thousands of jobs. That’s why Democrats, Republicans, business leaders, and economists have already said that these cuts, known here in Washington as the sequester, are a really bad idea.”

But for Rubio and many of his Republican colleagues the sequester is only about one thing, the military, calling them the “president’s devastating cuts to our military.” (more…)