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F I S C A L I M P A C T R E P O R T

SPONSOR Salazar

ORIGINAL DATE

LAST UPDATED

2/5/07

HB HJM 15/aHHGAC

SHORT TITLE Federal Indian Health Care Improvement Act

SB

ANALYST Weber

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY07

FY08

NFI

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Indian Affairs Department

Department of Health (DOH)

SUMMARY

Synopsis of HHGAC amendment

House Health and Government Affairs Committee Amendment to House Joint Memorial 15

amendment adds the following:

On page 4, line 2, after the semicolon insert "the secretary of the United States health and human

services department; the director of the United States Indian health service; the director of the

United States office of management and budget; the majority leader of the United States senate;

the speaker of the United States house of representatives; members of the United States senate

committee on Indian affairs; members of the United States house of representatives committee

on resources;".

This adds entities to receive the Joint Memorial but does not change the substance.

Synopsis of Original Bill

House Joint Memorial 15 urges the U.S. Congress and the President of the United States to

prioritize the reauthorization of the Indian Health Care Improvement Act early in the first session

of the 110

th

Congress. Additionally, HJM 15 calls for:

House Joint Memorial 15/aHHGAC – Page

2

1)

the state of New Mexico to support the addition of the city of Albuquerque to the Indian

Health Service (“IHS") list of demonstration projects;

2)

to support state-federal IHS health service partnerships; and

3)

to support access to residential treatment centers for Native American youth and

adolescents close to Indian reservations.

SIGNIFICANT ISSUES

The Indian Affairs Department contributes.

The United States has a federal trust responsibility, established by treaties, legislation, executive

orders, and court rulings, to provide health care services to members and certain descendants of

federally recognized tribes. The primary federal agencies responsible for providing health care

to Native Americans are the U.S. Department of Health and Human Services (“HHS") and the

Indian Health Service (“IHS"). The chief federal Indian health care legislation is the Indian

Health Care Improvement Act of 1976 (“Act"). The intent of the Act was to bring the health

status of Native Americans to the level of other populations and to end health disparities of

Native Americans.

According to a study conducted by the U.S. Commission on Civil Rights, federal funding for

Indian health care services is inadequate to address Native American health disparities:

“Native Americans have a lower life expectancy than any other racial/ethnic

group and higher rates of many diseases, including diabetes, tuberculosis, and

alcoholism. Yet, health facilities are frequently inaccessible and medically

obsolete, and preventive care and specialty services are not readily

available...The federal government spends less per capita on Native American

health care than on any other group for which it has this responsibility, including

Medicaid recipients, prisoners, veterans, and military personnel. Annually, IHS

spends 60 percent less on its beneficiaries than the average per person health

care expenditure nationwide.

The IHS, although the largest source of federal spending for Native Americans,

constitutes only 0.5 percent of the entire HHS budget…the agency currently

operates with an estimated 59 percent of the amount necessary to stem the crisis."

In March 2003, the New Mexico Department of Health (“DOH") published “Health Disparities

in New Mexico: Identifying and Prioritizing Disparities." The extensive study revealed that,

“Native Americans generally experienced the worst rates [of health disparities and] …had the

highest rates of diabetes death, pneumonia/influenza death, alcohol-related death, [and cirrhosis

death]."

The DOH study also revealed that Native Americans had the highest death rate among all

races/ethnicities in New Mexico. The rates for infectious diseases among Native Americans

were also the highest for Shigellosis and Salmonellosis as were for behavioral risk factors such

as adolescent smoking, adolescent drinking and driving, adolescent illicit drug use, and

adolescent obesity.

MW/mt