Administration renews commitment to American Indians and Alaska Natives

Final policy makes an exemption from the shared responsibility payment available to individuals eligible for IHS services.

The Affordable Care Act permanently reauthorizes the Indian Health Care Improvement Act, provides new opportunities for health insurance coverage, eliminates cost sharing such as copays and deductibles, and provides special monthly enrollment periods for members of federally recognized tribes who enroll in health plans offered through the Health Insurance Marketplace.

Today, the Obama administration issued a final rule allowing all American Indians and Alaska Natives who are eligible to receive services from an Indian health care provider to receive an exemption from the shared responsibility payment if they do not maintain minimum essential coverage under the Affordable Care Act. Prior to development of the final rule, only a portion of the American Indian and Alaska Native population – members of federally recognized tribes – would have access to an exemption from the requirement to maintain minimum essential coverage under the law. The final rule reflects comments and feedback received from Indian Country through rulemaking and the tribal consultation process.

"The administration is taking steps to honor our historical commitment to the rights of American Indians and Alaska Natives and ensure that individuals protected under the Indian Health Care Improvement Act benefit from the special provisions in the Affordable Care Act," said Health and Human Services Secretary Kathleen Sebelius. "Today, we continue to fulfill our responsibility to consult and work with tribal communities."

Today's final rule adds a hardship exemption category for American Indians and Alaska Natives who are eligible to receive services through an Indian health care provider, such as the Indian Health Service (IHS) or tribally-operated facilities and Urban Indian clinics.

"We appreciate our tribal partners who advocated to ensure that all American Indians and Alaska Natives eligible for IHS can receive an exemption from the penalty for not having insurance coverage," said IHS Director Dr. Yvette Roubideaux.

As a result of this final regulation, all American Indians and Alaska Natives who are eligible to receive services from an Indian health care provider will have access to an exemption from the shared responsibility payment.

The final rule is available here: https://www.federalregister.gov/public-inspection