Statement of Administration Policy: H.R. 3724 - Indian Health Amendments of 1992

(SENT 9/15/92)
(House)
(Miller (D) CA and Waxman (D) CA)

The Administration has no objection to House passage of H.R. 3724 — under the rule adopted by the Rules Committee — provided that it is amended to delete the bill's new categorical program authorities and section 209(b). This latter provision would restrict the Indian Health Service's (IHS) third party liability reimbursement authority. Section 209(b) would prohibit IHS's right of recovery when the medical condition treated is covered under a tribe or tribal organization's self-insurance plan.

Exemptions from third party liability unfairly discriminate against the poor and unemployed Native Americans who have no other means of health care. IHS's discretionary appropriation provides a fixed amount of health care annually. To the extent these resources are used to care for Native Americans who are covered under a health plan, care available to Native Americans not covered is reduced — unless IHS can recover the cost of care from the covered beneficiary's health plan. Since IHS retains all collections, receiving reimbursement allows IHS to provide more health services, especially for unemployed and disadvantaged Native Americans.

Moreover, there is no compelling reason to exempt some employers from the legitimate liability their beneficiaries incur when they use health services. All employers, whether public or private sector, should be treated equally. There is no reason that tribal employers should be arbitrarily exempt from meeting their fiduciary obligation to their employees.