Authors: National Indian Health Board

Publication Year: 2015

Last Updated: 2016-09-27

Journal: National Indian Health Board

Keywords: Definitions of Indian, Affordable Care Act (ACA), Indian Health Service (IHS), Medicaid and the Children, Health Insurance Plan (CHIP), American Indians and Alaska Natives (AI/ANs)

Abstract:

The “Definitions of Indian” in the Affordable Care Act (ACA) are not consistent with the definitions already used by the Indian Health Service (IHS), Medicaid and the Children’s Health Insurance Plan (CHIP) for services provided to American Indians and Alaska Natives (AI/ANs). The ACA definitions, which currently require that a person is a member of a federally recognized Tribe or an Alaska Native Claims Settlement Act (ANCSA) corporation, are narrower than those used by IHS, Medicaid and CHIP, thereby leaving out a sizeable population of AI/ANs that the ACA was intended to benefit and protect.

With regard to provisions for AI/ANs, different sections of the ACA make reference three different places in the federal Indian law that create definitions of Indians. In each case, an Indian is a “member of an Indian tribe.” And, in each case, tribes is defined similarly, but not exactly the same. The difference between the three definitions of tribe is primarily the presence or absence of the word “pueblo” in the definitions. The differences in the definitions are so minor that it is difficult to understand why this is an issue at all. However, failing to streamline the definition will have big impacts on the Indian health system by creating a class of “sometimes Indians” who are eligible for certain benefits and not others, leading to confusion, increased bureaucracy, and inadvertently disadvantaging some AI/ANs who simply fall out of this narrow definition that was erroneously included in the law.

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Source: Link to Original Article

Source: https://www.nihb.org/tribalhealthreform/indian-specific-provisions/