A Senate panel approved legislation Thursday that would reauthorize and overhaul the system responsible for the delivery of health care services to American Indians.

If enacted, the measure (S 1200) would be the first Indian Health Service reauthorization in more than eight years, according to Indian Affairs Chairman Byron L. Dorgan, D-N.D. The panel approved the bill by voice vote.

The legislation seeks to increase access to quality medical care for American Indians. For many of them, Indian Health Service programs offer the only available care.

“I want to move this bill,” Dorgan said. “This reauthorization has been kicking around, back and forth, back and forth, for a long time.” The measure has been introduced in each Congress since the 106th (1999-2000) but has stalled, primarily because of disagreements over the structure and function of the health programs it would authorize.

Tom Coburn, R-Okla., raised concerns about issues that he believes are not adequately addressed by the bill. He said the reauthorization did not give sufficient emphasis to the prevention of alcoholism, diabetes and other chronic health problems.

Coburn also offered, but withdrew, an amendment to limit spending on management activities to 15 percent of the budget of the Indian Health Service.

“What we’re about to do is say we’re reauthorizing the Indian Health Care act, knowing, with a wink and a nod, that we aren’t solving the major problems in the system,” Coburn said.

Both reservation-based and non-reservation-based health care need improving in his state of Oklahoma, he said. “Those that need health care the most are the ones who are left waiting in line.”

Dorgan vowed to work with Coburn to address his concerns as the bill heads to the Senate floor. But he reminded <Coburn and others that the bill is just an authorization, not an appropriations bill.

“I want to work with you, but I have to say that unless enough money is appropriated, there is going to continue to be a full-scale rationing of health care services,” Dorgan said.

The bill would authorize “such sums as are necessary” for the health care service through fiscal 2017.

One new provision in this year’s Indian health bill would create a grant program for demonstration projects testing new ways of providing convenient health care services.

Another would authorize funds for efforts to prevent suicide among Indian youth.

A portion of the bill would amend the Social Security Act to address Medicare, Medicaid and State Children’s Health Insurance Program payments to American Indians. Those programs are under the Finance Committee’s jurisdiction, and Dorgan said the two panels worked together on them to speed approval in the last Congress.

A companion bill (HR 1328) was approved April 25 by the House Natural Resources Committee. Chairman Nick J. Rahall II, D-W.Va., called that measure “one of the most important bills the committee will consider this year.”