Frederica Freyberg:
The federal spending and tax bills propose deep spending cuts to health care, greatly impacting Wisconsin’s tribal communities. Here & Now reporter Erica Ayisi spoke with Shannon Holsey, president of the Stockbridge-Munsee Band of Mohican Indians, about how these proposed cuts could impact tribal clinics in the state. She’s here to describe that impact. Erica?

Erica Ayisi:
Fred. Tribal clinics like Stockbridge-Munsee Health and Wellness Center provide medical services to tribal members and community members, but proposed spending cuts to Indian Health Services, Medicare and Medicaid would cut across all Wisconsin tribes. This report is in collaboration with ICT, formerly Indian Country Today.

Shannon Holsey:
It’s not just a budget, it’s a trust and treaty responsibility that, you know, the United States has entered into with Tribal Nations for what was taken and what was supposed to be returned in the loss of our land.

Erica Ayisi:
Shannon Holsey, president of the Stockbridge-Munsee Band of Mohican Indians, says the tribe’s health and wellness center is partly funded by the Indian Health Service or IHS, a federal agency that provides tribal medical services across the country, including for Wisconsin’s 11 federally recognized tribes.

Shannon Holsey:
That is the unique relationship that exists and the agreements that were entered into by the United States and Tribal Nations.

Erica Ayisi:
While the proposed $8 billion budget for IHS is an increase, Holsey says the package lacks advanced appropriations that are needed for funding predictability.

Shannon Holsey:
What one of the existential threats of this big, beautiful bill is that they’re going to strip the advanced appropriations, and we’re going back into a dysfunctional cycle.

Erica Ayisi:
Funding the Tribes Health Center is complex.

Shannon Holsey:
It costs our nation about $16 million to operate it annually. Of that, it’s multifaceted in the resources that come. It’s a mix of both private insurance and Medicare.

Erica Ayisi:
27% of the tribal clinic’s funding comes from Medicare and Medicaid. According to the Congressional Budget Office, the proposed bill would reduce federal Medicaid by $793 billion.

Shannon Holsey:
We have a responsibility to our citizens as a sovereign nation, so it’s going to be up to our tribal government to come up with that offset to meet the basic needs and demands.

Erica Ayisi:
What are some of the health concerns that tribal members are facing in the community?

Shannon Holsey:
What we’re seeing in our community is disproportionate rates of people being diagnosed with heart disease, diabetes and cancer — alarming rates of cancer. And as you can imagine, that is, that will tax your health care system.

Erica Ayisi:
The bill also proposes adding job requirements to Medicaid. Holsey says she’s concerned that Wisconsin’s rural tribal communities could disproportionately lose coverage because of additional hurdles to accessing health care.

Shannon Holsey:
There hasn’t been a well thought out plan in terms of how that is accessed, but really what we’re talking about is a human rights issue.

Erica Ayisi:
Holsey says there’s room for compromise in the proposed federal spending and tax bill. But for her, access to health care for Wisconsin’s 43,000 tribal population is non-negotiable.

Shannon Holsey:
We also have a responsibility as Tribal Nations to make sure the federal government upholds our trust and treaty responsibility and robustly engage and remind the United States government and others that as sovereign nations, they have a responsibility to Tribal Nations.

Erica Ayisi:
Even as the wrangling over the federal spending tax bill continues, one provision of the Medicaid overhaul would eliminate the opioid abatement program. That’s a prevention program addressing the opioid epidemic affecting native communities across the state. Fred.

Frederica Freyberg:
Thank you, Erica.