[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 846 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. RES. 846
Recognizing the maternal health crisis among indigenous women in the
United States, which includes American Indian, Alaska Native, and
Native Hawaiian women, recognizing the importance of reducing mortality
and morbidity among indigenous women, and calling for urgent Federal
funding changes to ensure comprehensive, high-quality, and culturally
competent maternal health and family planning services are available.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 13, 2021
Ms. Craig (for herself, Mr. Aguilar, Ms. Davids of Kansas, Mr.
Grijalva, Mrs. Kirkpatrick, Ms. McCollum, Mr. O'Halleran, Ms. Roybal-
Allard, Ms. Underwood, and Mr. Kahele) submitted the following
resolution; which was referred to the Committee on Natural Resources,
and in addition to the Committee on Energy and Commerce, for a period
to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
RESOLUTION
Recognizing the maternal health crisis among indigenous women in the
United States, which includes American Indian, Alaska Native, and
Native Hawaiian women, recognizing the importance of reducing mortality
and morbidity among indigenous women, and calling for urgent Federal
funding changes to ensure comprehensive, high-quality, and culturally
competent maternal health and family planning services are available.
Whereas American Indian, Alaska Native, and Native Hawaiian women in the United
States suffer from life-threatening pregnancy complications, known as
``severe maternal morbidities'', twice as often as non-Hispanic White
women;
Whereas American Indian and Alaska Native women in the United States are more
than twice as likely to die from pregnancy-related causes as non-
Hispanic White women;
Whereas American Indian, Alaska Native, and Native Hawaiian women are more than
twice as likely to receive late or no prenatal care compared to non-
Hispanic White women;
Whereas American Indian and Alaska Native women in the United States experience
high rates of births by Cesarean section which exposes them to
additional risk of developing complications;
Whereas the rate of poverty among American Indian and Alaska Native women is
nearly double the national average for all people;
Whereas the Federal Government is required to provide health care services to
American Indians and Alaska Natives as a result of promises made in
hundreds of treaties with the Indian Tribes, authorized by the
Constitution, and reaffirmed by United States Supreme Court decisions,
Federal legislation, Executive orders, and Federal regulations;
Whereas the aforementioned body of authority makes up the foundation of Federal
Indian law and explicitly defines the Federal trust responsibility owed
American Indians, Alaska Natives, and Native Hawaiians based on their
political status;
Whereas Federal Indian law makes clear that Indian Tribes, American Indians,
Alaska Natives, and Native Hawaiians hold a political status, and are
not a racial group;
Whereas American Indians and Alaska Natives receive health care services, in
partial fulfilment of the Federal Government's trust responsibility to
the Indian Tribes, through health programs administered through the
Indian Health Service (IHS) and Tribes and Urban Indian Organizations
(UIOs), collectively known as the ``ITU'' or ``IHS/Tribal/Urban'';
Whereas the Native Hawaiian Health Care Act of 1988 recognizes the special
responsibilities and legal obligations to Native Hawaiians resulting
from the unique history between the United States and Native Hawaiians;
Whereas Native Hawaiians receive health care services, in partial fulfillment of
the Federal Government's trust responsibility to the Native Hawaiian
community, through health programs administered through Papa Ola Lokahi
and the Native Hawaiian health care systems;
Whereas indigenous women benefit from increased resources and access to
community-based health care facilities, including indigenous midwives,
doulas, and birth centers;
Whereas the IHS, as part of the Department of Health and Human Services,
operates health care facilities and administers and provides funding to
health programs, including ITU facilities for American Indians and
Alaska Natives, but remains severely underfunded and lacks resources to
provide adequate health care services for American Indian and Alaska
Native women that are culturally competent, including prenatal care,
labor and delivery services, and a full range of culturally informed
family planning services;
Whereas the lack of funding and resources at IHS severely limits the ability of
the ITU to provide health care services and administer health programs
to American Indians and Alaska Natives;
Whereas the United States Commission on Civil Rights found that American Indian
and Alaska Native health care provided through IHS is inequitable and
unequal with Federal expenditures per capita that remain well below
other Federal health care programs and only cover a fraction of the
health care needs for American Indians and Alaska Natives;
Whereas, in 2019, IHS health care expenditures per person were $4,078, compared
to $9,726 for Federal health care spending nationwide;
Whereas historical trauma and gender oppression, coupled with the social
determinants of health inequities experienced by indigenous women in the
United States, is further perpetuated by severe underfunding of ITU
facilities that continue to contribute to the disproportionately high
rates of American Indian and Alaska Native maternal mortality and
morbidity rates;
Whereas culturally inadequate and institutionalized discrimination perpetuated
by the Federal Government's failure to uphold the trust responsibility
by adequately funding health care services for American Indians, Alaska
Natives, and Native Hawaiians continues to play a consequential role in
their health care experiences and outcomes;
Whereas fully funding the Federal Government's trust and treaty health care
responsibilities, especially for reproductive health care services and
maternal health programming, is critical to closing the maternal health
disparity gap when receiving care at ITU facilities, and health services
for indigenous women generally; and
Whereas culturally competent models for women's health services are needed to
provide appropriate maternal health, family planning, and child health
services for American Indian, Alaska Native, and Native Hawaiian women
at IHS, UIOs, non-IHS facilities, and Native Hawaiian health care
systems: Now, therefore, be it
Resolved, That the House of Representatives--
(1) acknowledges the unacceptable maternal health crisis
that indigenous women disproportionately experience resulting
in the exceedingly high rates of maternal mortality and
morbidity in the United States;
(2) calls for urgent Federal funding increases for the
Indian Health Service (IHS), Tribally Operated Health Centers,
Urban Indian Organizations, and Native Hawaiian health care
programs to ensure American Indians, Alaska Natives, and Native
Hawaiians have access to comprehensive, high-quality, and
culturally competent maternal health, prenatal care, and
comprehensive family planning services;
(3) recognizes the Federal Government's failure to uphold
Tribal treaty rights as it pertains to providing adequate
health care services to American Indians and Alaska Natives;
and
(4) calls upon the Department of Health and Human Services,
IHS, and the Health Resources and Services Administration
(HRSA) to prioritize policy for American Indian, Alaska Native,
and Native Hawaiian women to reduce long-standing and well-
known barriers to access culturally competent maternal health
and comprehensive family planning services.
<all>