Officials at clinics in Billings, Great Falls and Helena have said they may have to close if funding is not restored.
The impact, they said, would be devastating.
The funding supports 34 urban Indian nonprofit groups that provide health care services at 41 sites throughout the United States for 430,000 eligible Indian users, the letter states.
The clinics provide affordable treatment for a population more likely than the general population to die from certain diseases, including diabetes, alcoholism, tuberculosis, influenza and pneumonia.
The Bush administration argues that urban Indians live near hospitals and have access to federal, state and local programs and proposed slightly increasing the funding for the Health Centers program.
At a February hearing on the 2007 budget, Health and Human Services Secretary Mike Leavitt said patients at Indian Health Service clinics could go instead to community health centers.
“That just feels inefficient to me to be creating a separate system for one population of people when we are trying to create a much better system for everyone,” Leavitt said.
But the group of senators responded that increasing the use of other health centers “will place a much larger burden on a system already operating at capacity to the detriment of both non-Indian and Indian users.”
“Without access to affordable and accountable health care centers, we fear that many urban Indian families will go without the services the federal government has been tasked with providing them,” the letter states. “It is irresponsible to deny health care access to such to such a large and underserved population.”
The letter went to Sen. Conrad Burns, R-Mont., as chairman of the Interior Appropriations Subcommittee, and to the subpanel's ranking Democrat, Sen. Byron Dorgan, D-N.D.
Burns believes that zeroing out the urban health clinics is “not acceptable,” said spokesman Matt Mackowiak. He noted that it's early in the congressional budget process and said Burns is working to identify witnesses for a hearing on the subject in early May.
The U.S. House is also expected to hold hearings on the topic in May.
If the administration expects community health centers to fill the need, then more funding should be provided to them through the Health and Human Services budget, Mackowiak said.
“Chairman Burns is not satisfied. He's going to work closely with the administration and the committee to deliver an appropriate and acceptable solution in that area,” Mackowiak said.
Dorgan introduced an amendment that Baucus co-sponsored to provide $1 billion more than the proposed budget for various programs that benefit American Indians, including $40 million for the urban Indian health program. He said the proposals would be fully funded by closing corporate tax loopholes.
“All of us in this chamber know there are neighbors among us in this country who live in Third World communities,” Dorgan said. “We have a bona fide federal crisis in health care, education and housing on Indian reservations. We have a trust responsibility for the health care of American Indians.”
The amendment failed on a largely party-line vote of 42-56 on March 16.
Republicans argued that the amendment didn't guarantee that the money would go to the tribal authorities.
“All it does is raise the (budget) cap by $1 billion - increases taxes by $1 billion,” said Sen. Judd Gregg, R-N.H., chairman of the Senate Budget Committee. “It is entirely up to the Appropriations Committee how they spend money. We have no control over that. The practical effect of this amendment is simply tax and spend.”
Baucus voted for the amendment. Burns voted against it.
The Billings clinic is the largest of five urban Indian health centers in Montana, including Butte and Missoula, which serve about 6,000 to 7,000 patients each year.
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