Statement of Administration Policy: H.R. 5261 - Indian Health Care Amendments of 1988

(House)
(Waxman (D) CA and Udall (D) AZ)

The Administration opposes House passage of H.R. 5261. The Administration is strongly committed to the continued improvement of the health status of American Indians and Alaska Natives, and believes that an extension of existing authorities, coupled with the improvements advanced in the President's FY 1989 Budget, would better serve that objective than the numerous micromanagement provisions of H.R. 5261.

H.R. 5261 is highly objectionable because it would:

—    authorize excessive appropriations totaling $476.8 million for FYs 1989-1993, nearly $100 million above the amounts in the President's Budget for those years, and create the basis for other significant cost increases through various programmatic expansions and eligibility changes;

—    unnecessarily restrict the ability of the Indian Health Service (IHS) to respond to the complete health needs of the individuals it serves by extending a number of narrow, special interest categorical programs and establishing several new, unneeded programs. With its current broad authorities, the IHS can more effectively serve its eligible population;

—    require the IHS to be first payor for health services to certain Indians in Montana, a provision similar to one that was a major reason for the President's veto of predecessor legislation in 1984;

—    dilute resources going to eligible Indians who are members of federally-recognized tribes or who live on or near Indian reservations by expanding eligibility to cover several currently ineligible groups of Indians in California;

—    maintain redundant sanitation construction authorities already in the Department of Housing and Urban Development;

—    duplicate flexible authorities contained in the Snyder Act and require numerous burdensome anc^ costly regulations, reports, studies, and other new program responsibilities unrelated to the IHS basic health services delivery mission, the implementation of which would excessively and wastefully consume time and resources; and

—    establish a number of other highly undesirable restrictions on the IHS, such as a prohibition on the use of a Food and Drug Administration-approved medication, Depo-Provera, and attempt to dictate the form and content of the annual budget submission.