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The Affordable Care Act

What is it and how will it impact Indian Country?

Published: June 30, 2014
Healthy Tribes
Affordable Care Act

The Affordable Care Act (ACA) has been a widely discussed topic in recent months. Some question whether or not the ACA will truly benefit Americans. The reality is the ACA will prove to be positive for many, including our country's Native peoples.

President Barack Obama signed the Affordable Care Act on March 23, 2010. The ACA immediately put in place comprehensive health insurance reforms that were intended to roll out over four years and beyond. In fact, in 2010, a new Patient's Bill of Rights went into effect, protecting consumers from the worst abuses of the insurance industry. Cost-free preventive services began for many Americans. For millions, this was great news.

However, despite the fact that the ACA became a law on March 23, 2010, there continues to be much misinformation circulating about it both in the news and among the general public.

It will be the mission of this first blog posting to set the record straight with the facts. What is the ACA and how will it affect Indian Country?

On Aug. 23, 2013, Dr. Yvette Roubideaux, acting director of the Indian Health Service, delivered this statement, which explains the ACA and its benefits to Native peoples in a nutshell:

“The purpose of the Affordable Care Act is to increase access to quality health coverage for all Americans, including our First Americans. The benefits of the health care law for American Indians and Alaska Natives are significant whether they have insurance now, want to purchase affordable insurance through the Health Insurance Marketplace or take advantage of the States expanding Medicaid starting in 2014. Indian elders will benefit from a stronger Medicare with more affordable prescriptions and free preventive services no matter what provider they see.”

There was another “plus” for Native tribes, as Roubideaux went on to explain, and that is the fact that the Indian Health Care Improvement Act (IHCIA) was made permanent by the ACA. No more worry about the IHCIA going away. It’s now here to stay and that is very good news.

Here are the facts when we break down the ACA and apply it to American Indians and Alaska Natives:

Fact: The Affordable Care Act will provide 579,000 uninsured American Indians and Alaska Natives an opportunity to get affordable health insurance coverage.

Fact: The Affordable Care Act will help make health insurance coverage more affordable and accessible for millions of Americans, including this country’s first peoples. For American Indians and Alaska Natives, the law will address inequities and increase access to quality, affordable health coverage, invest in prevention and wellness, and give First American individuals and families more control over their care.

Fact: At the Department of Health and Human Services (HHS), tribal consultation is a critical ingredient of a sound and productive Federal-tribal relationship, and crucial to the successful implementation of the ACA. Consultation and outreach efforts provide education and information about the law and how it will impact Indian Country while ensuring policies and programs are responsive to feedback from tribal communities.

Improvements to our health care system have already started happening across Indian Country and more will start to take place beginning in 2014. Now, this is something that Indian Country can really get behind and support! Stay tuned to this blog for more news and updates on how the ACA will help you, your family and your community. We welcome your questions and comments.

To learn more about the Health Insurance Market Place, visit

For the most recent information on the Affordable Care Act and IHCIA implementation, visit: and