What the Affordable Care Act means for Indian Country

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Along with making health insurance more accessible and more affordable when he signed the Affordable Care Act (ACA) into law two years ago, President Obama also permanently reauthorized the Indian Health Care Improvement Act (IHCIA), which extends current law and authorizes new programs and services within the Indian Health Service (IHS).

Through constant communication with Indian Country, IHS Director Yvette Roubideaux and the Department of Health and Human Services (HHS) were able to ensure a successful implementation of the ACA within Indian Country that benefits all American Indians and Alaska Natives, including urban Indians. Such benefits include:

  • State-based health exchanges allowing individuals and small businesses to comparison shop and choose the most affordable insurance option that is right for them.
  • No cost-sharing or co-payments for certain American Indians and Alaska Natives who purchase insurance through the exchange and whose income is under 300 percent of the federal poverty level.
  • Value of health services and benefits from IHS funded health programs or Tribes will be excluded from an individual’s gross income and will not be taxed.
  • Medicaid expansion to individuals with incomes up to 133 percent of poverty level providing more American Indians and Alaska Natives an opportunity for coverage while expanding the opportunity for Indian health programs’ third-party collections.

In addition to the above benefits, the reauthorization of the Indian Health Care Improvement Act ensures that the Indian Health Service is more equipped to meet its mission to raise the health status of American Indians through:

  • Expanded IHS services, including mental and behavior health treatment and prevention, long-term care services, dialysis services and more
  • Increasing clinician recruitment and retention in Tribally operated health programs and encouraging health professionals to join or continue in an Indian health program and to provide services in rural/remote areas
  • Access to federal insurance from the Federal Employees Health Benefits Program

These are historic and important changes that will benefit all of Indian Country. To find out more about how the Affordable Care Act and the Indian Health Care Improvement Act help American Indians and Alaska Natives visit