Sam Brownback today vowed to fight federal health reform, "every step of the way," if he is elected governor.
But Native Americans, who are some of the Republican's staunchest supporters, are hoping that's an empty campaign promise.
"The health reform law is good for Indian Country," said Jennifer Cooper, legislative director for the National Indian Health Board, in Washington, D.C.
The board is a non-profit organization whose members represent the nation's tribes on health issues. Board members studied and discussed the health reform law for months before it was passed and agreed it was good legislation. So did other groups representing American Indians, including the National Congress of American Indians, the National Council of Urban Indian Health and the National Indian Gaming Association, all of which supported the law.
Health issues have been important to Native Americans since anyone can remember, said Stacy Bohlen, executive director of the National Indian Health Board.
Jim McLean’s KPR story: Tribes react to Brownback health reform pledge
"When our ancestors and forebears were negotiating treaties, even given the incredible pressures of losing an entire way of life, they always went into negotiation with three items of top importance: health, education and housing," Bohlen said. "And throughout time, the health of Indian people has remained a consensus priority. Like any group in America, there are many issues on which we differ. But when it comes to health care, it's a different matter. We have some of the most staggering health statistics; not just in the U.S. but some of the worst statistics in the world."
Native Americans in the U.S. have higher disease rates and lower life expectancy than any other racial or ethnic group, with exponentially higher rates of diabetes, mental disorders, cardiovascular disease, pneumonia, influenza and injuries. The infant mortality rate is 1.5 times greater for Indians than whites. They have the highest rate of Type 2 diabetes in the world and life expectancy five years less than the rest of the population. Poverty has been a persistent problem and suicide is increasing at an alarming pace.
Bohlen described the health reform law as, "a matter of life and death," for Native Americans. Key provisions of the reform, praised by the group, include the expansion of Medicaid to cover all adults with annual earnings of 133 percent or less of federal poverty guidelines, or about $15,000, and permanent reauthorization of the Indian Health Care Improvement Act, which is included in the massive reform's many provisions.
Given tribal support for health reform it is no surprise that the lead editorial in last week's "Indian Country Today," newspaper urged its readers to get behind the Obama administration and Democrats in the upcoming mid-term congressional races, in large measure because of health reform.
"The national story about this off-year election has already been about the Tea Party and the voter anger that’s demanding a different kind of government," wrote opinion columnist Mark Trahant, "But there is another story; the one about how the Obama administration has done what it said it would do for the nation’s American Indian and Alaska Native communities. It would be a shame for that story to drift off without an ending because not enough people organized, invested money in candidates or voted. Indian country needs to step up and protect the president’s back."
Apology from a good listener
Still, the Potawatomis and the Kickapoos in Kansas and other tribes across the country are big Sam Brownback fans. Tribal leaders have supported Brownback with public comments and with checks to his campaign treasury in spite of his stance on health reform, the law which on Monday he called, "an abomination."
Brownback, who will retire from the U.S. Senate regardless if he is elected governor, like every other Republican in Congress voted against health reform and since it became law has been a leading voice calling for its repeal or defunding.
But in 2004, he began pushing Congress to pass a resolution offering a formal apology to Native Americans for the wrongs and violence against them by the federal government over the course of history. It was a measure of tremendous symbolic power, especially for Native Americans, and its only expense to the treasury was printing costs.
Congress finally agreed to the apology last year and President Obama signed it in December. That same month, tribal interests in Kansas and western New York, donated at least $14,000 to advance Brownback's gubernatorial bid, according to the candidate's campaign finance reports.
"I do believe they (Native Americans) would support me regardless (of health reform) based upon the work I've done on significant tribal issues," Brownback told KHI News Service.
And that seems to be the case.
Tribal/state health council
Kansas tribal officials said Brownback has long been willing to listen to their concerns and they are confident that if he is elected governor he will help them forge formal communication ties with Kansas government, something they said was lacking through the administrations of Gov. Kathleen Sebelius and her successor Mark Parkinson until recently when a meeting was held with Roderick Bremby, secretary of the Kansas Department of Health and Environment.
"Sam has already been up and met with us and assured us we would have that relationship. He understands Indian Country from his time on the federal level. He got the Apology passed," said Potawatomi Tribal Chairman Steve Ortiz, who also goes by the Potawatomi name Mon-wah.
Ortiz is vice chairman of the Oklahoma City Intertribal Health Board, which despite its name includes representatives from Texas, Oklahoma and Kansas, the same states covered by the regional office of the Indian Health Service. The Oklahoma health board has formal links with Oklahoma health officials, which has benefited the tribes and the state, according to the board's executive director, Diddy Nelson.
Ortiz said he was hopeful that with Brownback as governor, Kansas tribes would be able to form a similar entity here in partnership with state officials. He cited the need to cooperate or at least be aware of mutual interests ranging from emergency preparedness for disease outbreak to child support enforcement.
The Potawatomi Tribe has a successful casino operation near Mayetta north of Topeka. Gaming revenue has funded a burst of construction and development on the Potawatomi reservation in the last few years, including new dental and health clinics, a pharmacy, a long-term care facility, a tribal judicial center and a soon-to-open $8.2 million golf course, which tribal members inaugurated last week. The tribe has become a leading Jackson County employer with more than 1,000 people on its payroll at the casino, health care facilities and tribal offices.
"Born Indian, die white"
Ortiz said among the things he hoped would happen from working more closely with state officials would be a better accounting of disease and mortality rates among tribal members. The incidence of breast cancer, for one, is woefully misreported, he said because death certificates usually fail to note that the deceased was Native American.
"The ironic thing is you're born an Indian and you live your life in the Indian Health System but when you die you're white," he said. "Really, you're an Indian but that doesn't get in the statistics, so that data gets out there for the wrong population."
Accurate data could help improve cancer screening and other prevention efforts, he said.
The Kickapoos also are, "very interested," in a state/tribal health council and other formalized communication links with the state, said Tribal Chairman Arlan Whitebird, another Brownback fan in Indian Country.
"I think that he's been pretty outstanding and productive as a senator overall and in general, let alone on Native American or Indian Country issues," Whitebird said of Brownback. "He does take the time. He does listen."
Brownback said he hadn't discussed with tribal leaders the particulars of a state/tribal health council, but he has met with the leaders from the four Kansas tribes to discuss the possibility of a direct link between them and the Governor's Office, perhaps blossoming into "point-to-point" communication between the tribes and cabinet-level state agency chiefs.
He said he grew up with an interest in Native American history. His family's farm near Parker was close to the initial settlement for the Potawatomis when they were relocated to Kansas from the Great Lakes region in the early 19th century. A park near his boyhood home honors St. Rose Phillipine Duschene, one of a handful of Roman Catholic saints canonized for their work in the United States.
"She did most of her work with the Potawatomis," Brownback said.
Brownback, who began his political career as state agriculture secretary, converted to Catholicism while in Congress. Reconciliation is one of the seven Catholic sacraments.
Brownback said his interest in pushing through the Apology to Native Americans developed after talking with Senate colleague Ben Nighthorse-Campbell of Colorado, who is Native American, and reading books such as "Healing America's Wounds," by John Dawson, a New Zealander who founded the International Reconciliation Coalition, a group of Christian leaders with the goal of easing and redressing long festering societal wrongs.
As appreciative as they are of Brownback's work on the Apology, however, Native American leaders said they also are looking forward to the healing benefits they expect from the health reform law he would like to dismantle.
What do you do when your favorite candidate is also stridently opposed to a law you are convinced will help your community?
"That's a Catch 22," said Cooper of the National Indian Health Board and a member of the Seneca Nation, which wrote a $2,000 check to the Brownback for Governor campaign in December 2009. "You want to be able to work with your state's leadership beyond health issues. But the other side of that is that health care reform was a major victory for Indian Country."