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Letter to Chair and Ranking Member of the Senate Appropriations Subcommittee on Interior, the Honorable Dianne Feinstein and the Honorable Wayne Allard

Boxer Leads Call to Restore Bush Cuts to Urban Indian Health Programs

U.S. Senators Barbara Boxer (D-CA) and John Thune (R-SD) led a bipartisan group of their colleagues today in sending a letter to the Chair and Ranking Member of the Senate Appropriations Subcommittee on Interior, urging them to restore funding for the Urban Indian Health Programs. President Bush's Fiscal Year 2009 budget eliminates funding for the program - leaving 430,000 eligible Indian users in 41 cities, including nine cities in California, without direct access to health care.

The full text of the letter to Senators Feinstein and Allard follows:

March 10, 2008

The Honorable Dianne Feinstein The Honorable Wayne Allard
Chairman Ranking Member
Subcommittee on Interior Subcommittee on Interior
Committee on Appropriations Committee on Appropriations
United States Senate United States Senate
Washington, DC 20510 Washington, DC 20510

Dear Chairman Feinstein and Ranking Member Allard:

We are writing to express our support for FY2009 funding of the Urban Indian Health Programs (UIHPs) and to request that funding be restored at a level of $40 million for the next fiscal year. The President's budget proposal eliminates funding for 34 urban Indian non-profit organizations providing health care services at 41 sites throughout the U.S. for 430,000 eligible Indian users.

In 1976, Congress passed the Indian Health Care Improvement Act, PL. 94-437, to address poor health conditions in Indian Country. Title V of this law specifically targeted funding for the development of programs for American Indians and Alaska Natives living in urban areas. The 2000 census indicated that as many as 66 percent of all American Indians and Alaska Natives live in urban areas. Urban Indian populations are integral members of communities such as Los Angeles, Seattle, Portland, Detroit, Chicago, Denver, Baltimore, Boston, Phoenix, Omaha, Fort Lauderdale, Oklahoma City, Wichita, Reno, Sioux Falls, Albuquerque, Minneapolis, Milwaukee, and Billings, among many others.

The Indian population suffers from diabetes, alcoholism, tuberculosis, influenza, and pneumonia at significantly higher rates than the general population. Urban primary care clinics and outreach programs provide culturally accessible, affordable, and accountable health services to our nation's large off-reservation Indian population. UIHPs participate in a wide range of activities, including outreach and referral services, ambulatory health care, health assessment, health promotion, disease prevention, child abuse prevention, and immunization services.

The Indian Health Service estimates that average funding in previous budget years has been 22 percent of the projected need for this program, and that eighteen additional cities have an urban Indian population large enough to support a UIHP. UIHPs are all operating at maximum capacity, servicing over 2 million visits per year.

We are committed to fiscal responsibility and understand that restraints on funding are a reality of the current budgetary climate - eliminating an already under funded program that hundreds of thousands of Americans have depended on since 1976 is not a choice we can support. Without access to health care centers, we fear that many urban Indian families will go without these important services. It is irresponsible to deny health care access to such a large and underserved population.

We believe that the President's FY09 budget proposal to eliminate the UIHP would have detrimental effects on urban Indian communities across the country; moreover, given the flat levels of funding for this program in previous years we urge you to fund this program at a level of $40 million dollars for FY2009. Thank you for your consideration of this request.


U.S. Senator Barbara Boxer U.S. Senator John Thune
U.S. Senator Maria Cantwell U.S. Senator Jeff Bingaman
U.S. Senator Gordon Smith U.S. Senator Ken Salazar
U.S. Senator Tim Johnson U.S. Senator Max Baucus
U.S. Senator Russ Feingold U.S. Senator Debbie Stabenow
U.S. Senator Barack Obama U.S. Senator John Kerry
U.S. Senator Carl Levin U.S. Senator Sam Brownback
U.S. Senator Ron Wyden U.S. Senator Lisa Murkowski
U.S. Senator Jon Tester

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