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                                                      Calendar No. 135
116th Congress      }                                   {       Report
                                 SENATE
 1st Session        }                                   {       116-54

======================================================================



 
 TO ALLOW TRIBAL GRANT SCHOOLS TO PARTICIPATE IN THE FEDERAL EMPLOYEE 
                        HEALTH BENEFITS PROGRAM

                                _______
                                

                  July 9, 2019.--Ordered to be printed

                                _______
                                

           Mr. Hoeven, from the Committee on Indian Affairs, 
                        submitted the following

                              R E P O R T

                         [To accompany S. 279]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Indian Affairs, to which was referred the 
bill (S. 279) to allow tribal grant schools to participate in 
the Federal Employee Health Benefit program, having considered 
the same, reports favorably thereon without amendment and 
recommends that the bill do pass.

                                PURPOSE

    The bill is intended to improve the education of students 
by allowing Bureau of Indian Education (BIE) tribal grant 
school employees to be eligible for participation in the 
Federal Employee Health Benefits (FEHB) and the Federal 
Employees Group Life Insurance (FEGLI) programs.

                  BACKGROUND AND NEED FOR LEGISLATION

    The BIE administers a school system that serves 
approximately 47,000 elementary and secondary students 
attending 183 schools and dormitories located in 23 states.\1\ 
The BIE directly operates 54 schools. Indian Tribes operate BIE 
``contract'' schools through the Indian Self-Determination and 
Education Assistance Act (ISDEAA)\2\ and BIE ``grant'' schools 
through the Tribally Controlled Schools Act of 1988 (TCSA).\3\
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    \1\The Bureau also supports post-secondary institutions in Indian 
Country, including two federally-operated post-secondary schools.
    \2\Pub. L. No. 93-638.
    \3\Pub. L. No. 100-297.
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    In 2010, Congress added section 409 to the Indian Health 
Care Improvement Act (IHCIA). This new section authorizes 
Tribes with ISDEAA contracts and urban Indian organizations 
operating health programs under IHCIA Title IV to purchase FEHB 
and FEGLI coverage for their employees. Tribes and urban Indian 
organizations that participate in these two programs cover the 
full cost of the employer share and, as a result, the Federal 
government incurs no additional costs when eligible Tribal and 
urban Indian employers opt into these programs.
    However, IHCIA section 409 does not reference BIE grant 
schools in the list of eligible FEHB and FEGLI participants. As 
such, Tribally-operated BIE grant schools cannot equally access 
the benefits extended to Tribes under IHCIA section 409. The 
Department of the Interior's Office of the Solicitor and the 
Office of Personnel Management confirmed that BIE grants are 
ineligible to participate without a change to the statute in 
2012.\4\ According to the National Indian Education 
Association, the exclusion of BIE grant schools from IHCIA 
section 409 creates ``inequity in healthcare access among 
employees at tribal schools within the same community and 
across the nation.''\5\
---------------------------------------------------------------------------
    \4\Legislative Hearing to receive testimony on S. 279, S. 790, & S. 
832 Before the S. Comm. on Indian Affairs, 116th Cong. (2017) 
(statement of John Tahsuda, Princ. Deputy Assistant Sec'y of Indian 
Affairs, U.S. Dep't of the Interior).
    \5\Letter from Robert Butterfield, President, Nat'l Indian 
Education Association, to Sen.'s John Hoeven & Tom Udall, Chairman & 
Vice Chairman, S. Comm. on Indian Affairs (Apr. 30, 2019) (on file with 
S. Comm. on Indian Affairs).
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    Currently, all federally-operated BIE schools and four [of 
the five?] BIE contract schools participate in the FEHB and 
FEGLI programs.\6\ According to Principal Deputy Assistant 
Secretary of Indian Affairs John Tahsuda, access to these 
programs results in budgetary and staffing benefits for these 
schools. He testified, ``Participation in the FEHB Program 
reduced costs associated with providing employee benefits as 
well as aided organizations in their recruitment and retention 
efforts.''\7\
---------------------------------------------------------------------------
    \6\Supra note 2.
    \7\Id.
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    Many BIE grant schools face challenges covering the cost of 
benefits for their employees because they do not have access to 
lower-cost options through the FEHB and FEGLI. The National 
Congress of American Indians and the National Indian Health 
Board both note many BIE grant schools must then utilize a 
portion of their educational services funding to pay for health 
and life insurance plans.\8\ In turn, this extra cost burden 
reduces funding for other ISEP supported activities (e.g., 
textbooks, teacher's aides, and extracurricular programs).
---------------------------------------------------------------------------
    \8\Letter from Victoria Kitcheyan, Chairperson, Nat'l Indian Health 
Board, to Sen. John Thune (Apr. 12, 2019) (on file with S. Comm. on 
Indian Affairs).; Letter from Jefferson Keel, President, Nat'l Congress 
of American Indians, to Sen.'s John Hoeven & Tom Udall, Chairman & Vice 
Chairman, S. Comm. on Indian Affairs (Apr. 29, 2019) (on file with S. 
Comm. on Indian Affairs).
---------------------------------------------------------------------------
    Cecelia Firethunder, President of the Oglala Lakota Nation 
Education Coalition, testified in front of the Committee about 
the impacts of this cost burden on the six BIE grant schools 
located on the Pine Ridge Reservation.\9\ She noted, ``our 
schools, however, struggle to cover the costs of high health 
insurance premiums and deductibles . . . This, in turn, 
directly and adversely affects the consistency and quality of 
the educational services our students receive.'' She estimated 
that access to FEHB would save one BIE grant school on the Pine 
Ridge Reservation, the Little Wound School, $1,000,000 per 
year.
---------------------------------------------------------------------------
    \9\Legislative Hearing to receive testimony on S. 279, S. 790, & S. 
832 Before the S. Comm. on Indian Affairs, 116th Cong. (2017) 
(statement of Cecilia Firethunder, President, Oglala Lakota Nation 
Education Coalition).
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    Because of the potential benefits of participation, the 
National Congress of American Indians, National Indian Health 
Board, National Indian Education Association, the All Pueblo 
Council of Governors, the Great Plains Chairmen's Health Board, 
United Tribes of North Dakota, Saint Stephens Indian School 
Educational Association, the Santa Fe Indian School, and the 
Standing Rock Sioux Tribe support extending FEHB and FEGLI 
eligibility to BIE grant schools.

                          SUMMARY OF THE BILL

    The bill, S. 279, amends IHCIA section 409 to make 
tribally-operated BIE grant schools operating under the TCSA 
eligible to participate in the FEHB and FEGLI programs.

                          LEGISLATIVE HISTORY

    On January 30, 2019, Senators Thune and Rounds introduced 
S. 279, the Tribal School Federal Insurance Parity Act. 
Senators Udall, Heinrich, Barrasso, and Tester are cosponsors 
of the bill. On May 1, 2019, the Committee on Indian Affairs 
held a legislative hearing on S. 279. At this legislative 
hearing, John Tahsuda III, Principal Deputy Assistant 
Secretary--Indian Affairs, U.S. Department of the Interior, and 
Cecelia Firethunder, President, Oglala Lakota Nation Education 
Coalition, testified in support of the bill.
    On May 15, 2019, the Committee on Indian Affairs of the 
Senate met at a duly called business meeting to consider three 
bills, including S. 279. No Committee Members filed amendments 
to S. 279. The Committee passed all three bills, including S. 
279, en bloc by voice vote and ordered the bills, without 
amendment, reported favorably.
    Congressman Dusty Johnson introduced a companion bill, H.R. 
895, the Tribal School Federal Insurance Parity Act, on January 
30, 2019. The House of Representatives referred the bill to the 
Committees on Natural Resources, Oversight and Reform, and 
Energy and Commerce, of the House of Representatives. On 
February 15, 2019, H.R. 895, the Committee on Natural Resources 
referred the bill to the Subcommittee on Indigenous Peoples of 
the United States. Since receiving the referral, the 
Subcommittee has taken no action on the bill.
    During the 115th Congress, Senators Thune and Rounds 
introduced S. 3030, the Tribal School Federal Insurance Parity 
Act on June 7, 2018. The Senate referred the bill to the 
Committee on Indian Affairs. Senators Udall, Heitkamp, and 
Tester joined the bill as cosponsors on July 26th, August 2nd, 
and September 5th of 2018, respectively. After receiving the 
referral, the Committee took no action on the bill.
    On June 7, 2018, Representative Noem introduced a companion 
bill, H.R. 6030, the Tribal School Federal Insurance Parity Act 
in the House of Representatives, which referred the bill to the 
Committees on Natural Resources, Oversight and Government 
Reform, and Energy and Commerce. On June 12, 2018, H.R. 6030, 
the Committee on Natural Resources referred H.R. 6030 to the 
Subcommittee on Indian, Insular and Alaska Native Affairs. 
After receiving the referral, the Subcommittee took no action 
on the bill.

                      SECTION-BY-SECTION ANALYSIS

Section 1. Short title

    Section 1 states S. 279 may be cited as the ``Tribal School 
Federal Insurance Parity Act.''

Section. 2. Amendment to the Indian Health Care Improvement Act

    Section 2 amends section 409 of the Indian Health Care 
Improvement Act by inserting ``or the Tribally Controlled 
Schools Act of 1988 (25 U.S.C. 2501 et seq.)'' after ``(25 
U.S.C. 450 et seq.)''.

                   COST AND BUDGETARY CONSIDERATIONS

    The following cost estimate, as provided by the 
Congressional Budget Office, dated May 28, 2019, was prepared 
for S. 279:

                                     U.S. Congress,
                               Congressional Budget Office,
                                      Washington, DC, May 28, 2019.
Hon. John Hoeven,
Chairman, Committee on Indian Affairs,
U.S. Senate, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 279, the Tribal 
School Federal Insurance Parity Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Lori Housman.
            Sincerely,
                                                Keith Hall,
                                                          Director.
    Enclosure.

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
    

    The Affordable Care Act, Public Law 111-148, allows certain 
Indian tribes, tribal organizations, and urban Indian 
organizations to purchase health insurance through the Federal 
Employees Health Benefits (FEHB) program for their employees. 
The Office of Personnel Management administers the program, but 
the tribes or tribal organizations purchase the insurance for 
their employees and must pay at least 70 percent of the 
premium. The employees pay the rest.
    S. 279 would allow tribal grant schools (as defined by the 
Tribally Controlled Schools Act of 1988) to participate in that 
arrangement. Because the schools would be paying the employer 
share of the premiums for FEHB health insurance for their 
employees, enacting the bill would not affect the federal 
budget.
    The CBO staff contact for this estimate is Lori Housman. 
The estimate was reviewed by Leo Lex, Deputy Assistant Director 
for Budget Analysis.

               REGULATORY AND PAPERWORK IMPACT STATEMENT

    Paragraph 11(b) of rule XXVI of the Standing Rules of the 
Senate requires each report accompanying a bill to evaluate the 
regulatory and paperwork impact that would be incurred in 
carrying out the bill. The Committee believes that S. 279 will 
have minimal impact on regulatory or paperwork requirements.

                        EXECUTIVE COMMUNICATIONS

    The Committee has received no communications from the 
Executive Branch regarding S. 279.

                        CHANGES IN EXISTING LAW

    On February 6, 2019, the Committee unanimously approved a 
motion to waive subsection 12 of rule XXVI of the Standing 
Rules of the Senate. In the opinion of the Committee, it is 
necessary to dispense with subsection 12 of rule XXVI of the 
Standing Rules of the Senate to expedite the business of the 
Senate.

                                  [all]