Mr. YOUNG of Alaska. Mr. Speaker, I would like to speak to a provision of the Affordable Care Act (ACA) that I believe should be exempted from the wholesale repeal of ACA, and that is section 10221--which is the Indian Health Care Improvement Act (IHCIA) provisions of the bill. I urge my colleagues in the House of Representatives not to forget that with the repeal of the Affordable Care Act, there would also be a repeal of the permanent reauthorization of the IHCIA, which ensures that American Indians and Alaska Natives will have access to improved health care.
The IHCIA amendments enacted in 10221 of ACA were developed completely separate from ACA and had a distinct legislative history. The IHCIA amendments were developed in a more than decade long process involving tribes, tribal organizations of the federal government on how best to update the quite out of date IHICA--which had its last major reauthorization in 1992.
While I was a proponent of considering the IHCIA independently, ultimately the IHCIA provisions were included in ACA. The ACA was a legislative vehicle that was moving so that the IHCIA provisions could finally be enacted.
There are a number of key provisions within IHCIA that will greatly enhance the well being of tribal communities. Such provisions include: new and expanded authorities for behavioral health prevention and treatment services; authorities for demonstration projects including projects for innovative health care facility construction and health professional shortages; and authority for the provision of dialysis services.
The health of American Indian and Alaska Native people, who already endure some of the largest negative health disparities, should not be negatively affected because the IHCIA provisions, through chance, were included in ACA.