Sequestration has been particularly damaging to Native Americans and breaks promises made by treaties between the United States and the tribes. From 1778 to 1871, the U.S. ratified numerous treaties with various Native American tribes, explicitly guaranteeing education and health care services. Despite these treaties, tribal health care is critically underfunded, resulting in higher infant mortality rates, more disease and disability, and shorter life expectancies. Recent budget cuts, and in particular sequestration, are aggravating these problems.
Since 1871, commitments to Native American tribes have been codified through Executive Orders, Executive Agreements, and laws such as the Snyder Act of 1921 and the Indian Health Care Improvement Act of 1976. The latter states, “Federal health services to maintain and improve the health of the Indians are consonant with and required by the Federal Government’s historical and unique legal relationship with, and resulting responsibility to, the American Indian people.” Indeed, the Supreme Court uses language such as “contracts between sovereign nations” and “the contracting Indians” when speaking about treaties made with Native Americans. In this sense, the U.S. promised to provide certain benefits such as health care, education, and financial payments to pay for the lands. Shortchanging these services is therefore a breach of treaty.
Automatic, across-the-board cuts known as sequestration took effect in March, and they failed to protect Native American health despite the treaties. This year, $220 million was sequestered from the Indian Health Service (IHS), a nearly 5 percent cut. This has put a serious strain on its already inadequate budget. The White House estimated that the cut would cause tribal hospitals and clinics “to provide 3,000 fewer inpatient admissions and 804,000 fewer outpatient visits, undermining needed health care in Tribal communities.”
According to a 2011 CDC survey, 34.2 percent of Native Americans under 65 lack health insurance, far above the 17.2 percent national average. IHS serves 1.9 million people and struggles to meet their needs even when funding is less constrained. It habitually runs out of money partway through the year. A 2003 study by the U.S. Commission on Civil Rights found that “the federal government’s rate of spending on health care for Native Americans is 50 percent less than for prisoners or Medicaid recipients, and 60 percent less than is spent annually on health care for the average American.” This lower funding leads to noticeably worse health outcomes than for other Americans.
Sequestration is also being felt through decreased funding to Impact Aid, a program that provides additional education funding to school districts near military bases, Native American reservations, or federally owned land because those school districts receive less revenue from property taxes. This year, $65 million was cut from Impact Aid. For some schools near reservations, Impact Aid makes up as much as 60 percent of their budgets, and schools that have had to close have disproportionately been on reservations. A May 2013 report from the Center for Native American Youth predicted that sequestration cuts to the Department of Education would lead to staff reductions, cancelled programs, and shortened school years affecting nearly 115,000 Native American youths at 710 schools. Schools have been operating with leaking roofs and without hot water; others have been operating without guidance counselors, even though the Native American youth suicide rate is 10 times the national average.
The poverty rate on Native American reservations is 33 percent, and the rate of extreme poverty – the percent of people earning less than half the poverty rate – on large reservations is four times the national average. With poverty so high, the furloughs, layoffs, and hiring freezes that result from budget cuts exacerbate economic struggles. Low-income programs disproportionately aid Native Americans, so sequestration’s cuts to Indian health and Impact Aid, as well as nutrition assistance, Head Start, assisted housing, and other low-income programs, has inordinately affected them.
Most disturbingly, these budget cuts represent yet another broken promise to Native Americans. The cuts have a devastating effect on the welfare of Native Americans and continue one of the most shameful legacies in American history.
Bobby Kogan is an intern with the economics department at the Center for American Progress Action Fund.