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What do American Indians and Alaska Natives need to know about the Marketplace?


There seems to have been some confusion about whether Native American Indians and Alaska Natives will be required to purchase health insurance under the provisions of the Affordable Care Act (ACA).  On June 26, 2013 the Health and Human Services (HHS) Secretary Kathleen Sebeilius cleared up any possible confusion. She announced that “people who are eligible to receive medical care through the federal Indian Health Service will be exempt from the individual mandate of the ACA.”


This was an important announcement because there are 6.2 million people that identify themselves as Native American Indians and Alaska Natives that do not have health insurance.  The Indian Health Service Division of the Department of the HHS manages a number of clinics that serves these people. The Indian Health Service Division is required by treaties to serve all patients of Indian ancestry even if they are unable to prove their federal tribal status. There are 560 tribes that are recognized by the U. S. Bureau of Indian affairs. 


The June 26th announcement also made it clear that members of the more than 100 tribes that have not been recognized by the federal government will also be exempt from the individual mandate provision of the ACA.  Without the exemption Native Americans could be subject to a fine of up to $95 if they failed to buy their own health insurance.


It should be noted that the exemption from the provisions of the ACA was granted by the HHS and not incorporated into the law.  Caitrin McCarron, manager of congressional relations at the National Indian Health Board said, that the exemption was a stop gap measure and “Because it's not a legislative fix and it's the secretary's exemption waiver, a future secretary could reverse the policy."

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