Authors: National Indian Health Board

Publication Year: 2015

Last Updated: 2016-09-27

Journal: National Indian Health Board

Keywords: Definition of Indian, Affordable Care Act, ACA, Indian Health Services, IHS, Centers for Medicare & Medicaid Services, CMS, The Affordable Care Act (PL 111-148)

Abstract:

REQUEST: Enact legislation that would streamline the Definition of Indian in the Affordable Care Act (ACA) to conform with definitions used by IHS and the Centers for Medicare & Medicaid Services. For Senators, Co-sponsor S. 2114, introduced by Senator Lisa Murkowski (R-AK) which would provide a legislative fix to the Definition of Indian in the Affordable Care Act.

ISSUE: The Affordable Care Act (PL 111-148) contains several important provisions for Native Americans including permanent reauthorization of the Indian Health Care Improvement Act. However, certain portions of health care reform (aka “Obamacare”) contain different definitions of “Indian” which led to conflicting interpretations of eligibility for benefits and requirements for coverage. These definitions are different than those used by IHS and the Centers for Medicare and Medicaid Services and require that an individual be a member of a federally recognized Tribe. On June 26, 2013 HHS announced a hardship exemption waiver that exempts American Indians and Alaska Natives (AI/ANs) who are not members of federally recognized from the tax penalty if they do not carry health coverage. Although this is a positive step, it only temporarily fixes 1 of 3 issues. It does not address the monthly enrollment benefit or cost-sharing.

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