Top tribal health advocate steps down as tribes seek IHS advance appropriations
Aaron Payment decides not to move to Washington.
WASHINGTON — Aaron Payment, former chairman of the Sault Ste. Marie Tribe of Chippewa Indians, has announced that he is stepping down as legislative director with the National Indian Health Board (NIHB) after a brief, approximately 5-month tenure.
“With great gratitude and loyalty, I say Chi Megwitch (thank you) to the National Indian Health Board and their superstar CEO Stacy Bohlen for letting me be part of your purpose even if it was short lived,” Payment shared on social media yesterday. “I have only respect and appreciation.”
Payment said he had an agreement to work remotely from his home in the Upper Peninsula of Michigan until Nov. 1, but after that, the plan was that he would move to the D.C. area to advocate for tribal health needs from within the nation’s capital.
“The position absolutely has to be in DC as access and regular contact with the legislature and administration is imperative,” he wrote in his announcement.
However, familial concerns sidetracked Payment’s plans, he said, citing his foster children’s needs. He has also recently faced health difficulties and experienced the passing of a family member.
“Life happens,” he wrote. “The Creator has a plan. Our purpose is to seek to understand and live that purpose handed down to us. I stand ready.”
Payment resigned as chairman of the Sault Tribe in May after a contentious years-long political battle with the tribe’s board of directors over a variety of leadership squabbles.
After his resignation, which surprised many in Indian Country due to his longtime service of approximately 22 years on the tribal board, he soon announced he was joining the NIHB as its top legislative advocate.
Payment told Indigenous Wire in June that he would have liked to have been considered for the Special Assistant to the President on Native American Affairs position with the White House Domestic Policy Council, but he was not asked.
That position was abruptly vacated in the spring by Libby Washburn, a Chickasaw Nation citizen, after she served in the job for just over a year. After some tribal scrutiny of her decision-making and consultation, she left to become the director of ethics and compliance with the San Diego Zoo Wildlife Alliance.
Daron Carreiro, also a citizen of the Chickasaw Nation, has since taken over many of Washburn’s duties, having begun serving as the Senior Policy Advisor for Native Affairs on the White House Domestic Policy Council in April. Advisor PaaWee Rivera, a citizen of the the Pueblo of Pojoaque, has also picked up much of the slack.
Payment, meanwhile, has been a popular advocate on the national stage for the needs of Indian Country at-large, developing relationships with many current federal leaders, including Vice President Kamala Harris and Secretary of Energy Jennifer Granholm.
He had served in several leadership positions with the National Congress of American Indians advocacy organization and other national tribal committees over many years before being forced to step down from serving on national organizations by his tribe’s board of directors this spring.
Payment’s exit from the NIHB comes at a sensitive time for Indian Country, as many tribal health advocates are strongly pushing for advance appropriations for the Indian Health Service (IHS) to pass before the end of the current session of the U.S. Congress.
Such a funding mechanism would help IHS provide funds to tribes in a way that makes up for perennial shortfalls in the federal health funding stream to tribes. Funding lags result in some tribal health facilities being unfunded and/or underfunded for many months each year.
U.S. Sen. Lisa Murkowski (R-AK), currently up for re-election, is seen as a crucial voice in the Senate to getting advance appropriations passed.
“Sen. Murkowski has long supported and continues to support advance appropriations for the Indian Health Service,” Hannah Ray, a spokesperson for the senator, told Indigenous Wire in October. “She recognizes that IHS needs a budget that is sufficient, timely and predictable in order to ensure that American Indians and Alaska Natives receive the highest quality of medical care they deserve.”
Payment’s voice on this issue has been loud and clear over many years, and he has helped many legislators understand why tribes need and want it.
However, U.S. House members on the Democratic side of the aisle have lately been preventing a pathway for advance appropriations — much to the chagrin of tribal advocates who have noted that the Veterans Health Administration already receives such funding, yet the federal government has a trust obligation to tribes it seems to be ignoring.
Bohlen, the CEO of NIHB, has called the situation an “affront” to tribal sovereignty.
Murkowski’s office spoke to some of the complications involved here.
“With IHS, over half of its budget is contracted or compacted, which is foundational to tribal self-determination but a very different budgeting approach than is used by the VA for health care delivery,” Ray said. “Therefore, Congress must make sure to take into account these types of different budget mechanics in providing advance appropriations.”
Democratic lawmakers are said to be looking into the mechanics of a feasible plan that could earn bipartisan support, and the White House has already said it is on board to get it done.
U.S. Reps. Tom Cole (R-OK), a Chickasaw Nation citizen, and Sharice Davids (D-KS), a Ho-Chunk Nation citizen — leaders of the House Native Caucus — have been pressing their colleagues to support mandatory IHS funding.
“All other federal government healthcare providers — Medicare, Medicaid, Children’s Health Insurance Program, TRICARE, and Veterans Health Administration — are all either under mandatory funding or receive advanced appropriations,” they wrote in June to U.S. Rep. Rosa Delauro (D-CT), chairwoman of the House Committee on Appropriations. “IHS is the only major federal healthcare program that does not receive either and is up for annual appropriations.”
Payment has said he remains hopeful that advance appropriations will soon pass Congress, but for now, he is focused on helping his tribe, although he is not currently running for a position on the Sault Tribe board.
“I have pledged my support in any way the Board needs,” Payment said. “At a time of great transition and in celebration of our 50th anniversary as a federally recognized tribe, we all should pledge our support and commitment to our Tribe and our leadership. Please join me in supporting our Tribe and our future.”
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