Jeff Bingaman United States Senator from New Mexico

Mr. BINGAMAN. Mr. President, I rise in opposition to Senator Smith's amendment, No. 3897, to the Indian Health Care Improvement Act, S. 1200, and urge my fellow Senators to vote against this amendment.

This amendment would expressly authorize the Secretary of Health and Human Services, HHS, to utilize a new ``area distribution fund'' methodology to allocate Indian Health Service, IHS, health care facilities construction, HCFC, funding. 

This approach could result in critical projects that are on the current IHS HCFC priority list from receiving funding. These projects have been waiting for many years, and in some cases decades, to receive funding. Furthermore, section 301 of the underlying bill, which the Smith amendment would amend, represents the results of hours of bipartisan negotiations on this issue throughout the last 2 years. While I understand Senator Smith's desire to provide a possible avenue for his tribes to receive funding, this amendment would undo the very delicate compromise that was reached in the underlying bill. 

According to the IHS staff briefings, the entire concept of an area distribution fund does not guarantee that all IHS service areas receive HCFC funding; instead, it creates a new criterion that must be used to determine IHS HCFC funding priorities. The current criteria utilized by IHS are focused on directing funding to the IHS areas in most need, where IHS patients are most isolated and least likely to have access to care. This geographic criterion does not represent good policy but simply an attempt to spread the very paltry funding provided for IHS HCFC projects even more thinly based on location instead of need. Instead of playing games with the distribution formula, we in Congress should be working to ensure that there is adequate funding for IHS HCFC projects so that the current backlog is addressed and new projects from throughout the country may be added.