Montana’s Democratic Senator Jon Tester wants to know how the Trump administration’s proposed 2018 federal budget will affect the Indian Health Service.
So, on Wednesday Tester turned to the troubled agency’s new acting director, Rear Admiral Michael Weahkee for answers.
It didn’t go well.
Weahkee could not explain how much money IHS is billing Medicaid to help keep the agency running.
“I think it’s absolutely unbelievable that you can’t separate how much money that Medicaid has helped you with third party billing," Tester said, testily, "to the point where I think we should almost demand an audit. That’s not how things work.”
It rapidly went downhill from there for Weahkee, whose agency serves over 2 million American Indians and Alaska Natives. Indian Health Service has long been underfunded, and is widely criticized for its aging facilities, sub-par medical care and chronic staff shortages.
Under the 2018 federal budget, it’s facing cuts of about $300 million.
Tester asked Weahkee seven times during Wednesday’s Senate Indian Affairs and Appropriations committee meeting if he thought that budget proposal would help or hurt IHS’s staffing problems.
And seven times Weahkee refused to answer the question.
That didn’t sit well with Tester.
“If you guys don’t advocate for a budget, how the hell are we supposed to fix it?" Tester demanded.
"I have never had – in ten years on this committee – I have never had somebody come up here, and when I ask them a direct question they don’t answer it. I asked you a direct question on whether this budget was up or down and you refused to answer it. That is totally unacceptable. I did not come here with my hair on fire, but I’m leaving here with it. Indian Health Service is in a crisis. If you have served in Indian Health Service for ten years and you have answered the questions in IHS like you have here today than it’s no wonder that it’s in crisis. I cannot believe what has transpired in this hearing today. All I want are some damn answers.”
When contacted Thursday, Tester said he believes Weahkee knew exactly what he was doing during that hearing.
“He was told by somebody in the administration to support that budget under any circumstances.," Tester said. "The way the questions were set up; ‘What’s your greatest need?’
"‘We need more staff.'
"And then you walk in and say, ‘Ok, what’s in your staffing line item?’ and he dances around and won’t answer the question. It was very frustrating for me.”
IHS faces bipartisian criticsism:
“The tragedy of IHS cannot be overstated," said Montana's Republican Senator Steve Daines. "As I said during the hearing, IHS should stand for 'Indian Health Suffering,' because that’s what’s really going on in Indian Country.”
“Let the tribes have a greater say in their health care policies," Daines said. "There is tremendous bureaucracy within IHS where a lot of the dollars that come in the top of the funnel don’t end up at the bottom of the funnel to people who need it. Second, we’ve got to staff and fund the doctors and nurses. Right now, there’s far too many open head-counts."
Daines, who sits on the Senate Appropriations Committee, says IHS funding must be spent more effectively.
“We’ll most likely restore significant parts – to be determined – dollars in the IHS budget. We’re not going to solve the plight of Indian Country with IHS with the cuts that were proposed. But we need a robust funding discussion in terms of where those dollars are going to be spent," Daines said.
The reporting above was by Montana Public Radio's Edward O'Brien.
Yellowstone Public Radio's Brie Ripley spoke with Dan Frosch and Chris Weaver, reporters with The Wall Street Journal, who co-wrote an article on the deficiencies of IHS hospitals, which Alaska Republican Senator Murkowski read aloud from at Wednesday's hearing.
The investigative piece, published last week, details tragedy after tragedy of people dying at poorly funded, poorly organized IHS hospitals.
Here’s Reporter Dan Frosch: "I think what you saw from Senator Murkowski and Senator Tester, they were hoping that Admiral Weahkee would share in their outrage, or at least express a sense of urgency, in terms of his and IHS’ willingness to address some of these problems. Which, as we documented in our story, are oftentimes a matter of life and death. And you did not see that from him, Adm. Weahkee, as of yesterday. You saw, instead, very sort of staid responses about IHS and their commitment to making things better, but there was not, I think, the urgency, and the same sense of anger, about how Native folks will be treated at the hospitals, that the Senators were looking for."
And this is reporter Chris Weaver’s take on Wednesday’s hearing: "Part of the spectacle of yesterday’s hearing was to watch Republican Senators basically invite an agency chief to ask for more money, and then watch an Agency Chief refuse to do it."
When Weaver and Frosch went to the US Department of Health and Human Services for comment on the article they published last week, they never got it.
"Basically the only thing we ever heard back from them was that a spokesperson emailed to clarify that I was quote, 'asking them to comment on a situation they inherited,' Weaver said. "You know, as though these were all Obama administration problems."
And Weaver says that the fact that Admiral Weahkee is a temporary acting director is a sign that it’s unclear how committed the new administration is to addressing IHS problems.
"At his own confirmation hearing back in January," Weaver said, "President Trump's Health Secretary, Tom Price, said he was aware of the problems at the agency, and intent on fixing them… But the first step to solving that problem would be to put someone in charge of that ship."
After the hearing, Admiral Weakhee said in a statement to The Journal that he welcomes the opportunity to work with the Committee and will continue communication with members, and provide responses to information they requested during Wednesday’s hearing.
Frosch says he doesn’t think this response is particularly satisfying to the members of the Senate Indian Affairs committee.
"It goes back to something I mentioned earlier where you don’t get a sense of urgency from the Acting Director with regards to some of these problems he was being pressed on" Frosch said, "and I think what they were looking for was less, ‘I’m glad to be here and looking forward to working with the committee,’ as opposed to, ‘Please give us the resources we need to work to fix this problem, so we can fix it once and for all.’ There was really nothing coming from IHS like that yesterday."
Frosch says several congressional committees are expected to continue holding hearings on IHS issues in the coming months.