American Indians

American Indians

Attached to the Affordable Care Act is a re-authorization of the Indian Health Care Improvement Act, which was first passed in 1976 and last re-authorized in 2000.  The attachment makes it permanent, and it expands the services available to American Indians, including Alaskan tribes and urban Indians.  The expansion includes more mental and behavioral health services and dialysis.

American Indians or Alaska Natives may have new health insurance benefits and protections.

Some benefits are available to members of federally recognized tribes. Others are available to people of Indian descent or who are otherwise eligible for services from the Indian Health Service, tribal program, or urban Indian health program.

Protections and Benefits for American Indians and Alaska Natives

The Health Insurance Marketplace benefits American Indians and Alaska Natives by providing opportunities for affordable health coverage. This coverage can be bought through a private health plan bought in the MarketplaceMedicaid, or the Children’s Health Insurance Program (CHIP).

If you’re a member of a federally recognized tribe:

  • If you buy private insurance in the Health Insurance Marketplace, you won’t have to pay out-of-pocket costs like copayments, deductibles, and coinsurance if your income is up to around $70,650 for a family of 4 ($88,320 in Alaska). (These are 2013 figures, and likely to be slightly higher in 2014.)
  • You can enroll in Marketplace health insurance any month, not just during the yearly open enrollment period.

If you’re an American Indian or Alaska Native or are otherwise eligible for services from the Indian Health Service, tribal program, or urban Indian health program:

  • You have special cost and eligibility rules for Medicaid and the Children’s Health Insurance Program (CHIP) that make it easier to qualify for these programs.
  • If you don’t have health insurance, you won’t have to pay the tax penalty that most other people without health insurance must pay.

Indian Health Services and Marketplace insurance

If you enroll in a private health insurance plan through the Health Insurance Marketplace:

  • You can get (or keep getting) services from the Indian Health Service, tribal health programs, or urban Indian health programs.
  • You can also get services from any providers on the Marketplace plan.


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