From At-Large Tribal Council Member Julia Coates Hello, everyone – Summary: Several people have asked about the impacts of the Affordable Care Act on Native Americans, and this is worth discussing with the whole list. Today’s update will therefore cover the basic things that At Large American Indians should know about how the ACA works for them. American Indians who are citizens of federally-recognized tribal governments are exempted from the Affordable Care Act (ACA). There is a form, however, that one must file in order to receive the exemption. The form is attached. American Indians are exempted on the assumption that they are able to use Indian Health Service (IHS) hospitals and/or federally-funded tribal clinics. And if one lives in an area where one has access to an Indian hospital or clinic, that assumption may hold up. But the assumption on the part of the ACA does not reflect the reality of many American Indians who reside in areas where federal or tribal health facilities are not available. Therefore, if one does not have tribal clinics or an IHS hospital nearby, I would strongly encourage purchasing insurance through one’s state exchanges. Otherwise, if you do request an exemption, but have no Indian health facilities you can utilize, you would be responsible for the full amount of any medical bills. And even for those who do utilize Indian health facilities for routine health care, anything that cannot be handled in the facility itself – that must be contracted out – is not covered by either federal or Cherokee Nation funds for At Large citizens. These would be any of the major or “catastrophic” illnesses – heart disease, cancer, etc. – and again, if a person has claimed the exemption from the requirements of the ACA, they would be responsible for the entire cost of treatment, and as we all know, that is the kind of thing that can completely wipe out a family. So I strongly recommend to anyone who resides outside the boundaries and who does not have insurance through one’s employer, to purchase insurance through one’s state exchanges. (If one resides within CN boundaries, this is not as critical, since contract health will usually pick up all or almost all of any costs that result from be referred to specialists.) I am in committee meetings today, and in the Health Committee, we heard about a number of clinics and the two hospitals at Claremore and Tahlequah (Hastings). All report that they are seeing no change in the number of clients they’re seeing as a result of the implementation of the ACA, but Claremore Indian Hospital did report that the fact that some people are either losing or relinquishing their insurance through their employers but still utilizing Indian health facilities may account for the recent drop in revenue to the hospital. This is another possible consequence of the ACA and another reason for those who have insurance to use it when visiting Indian health facilities. The third party revenue from insurance is vital to maintaining the IHS system.
Posted on: Tue, 04 Feb 2014 03:32:26 +0000
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