The Benefits That IHS Current Patients Have

How Provisions of the Affordable Care Act/ Obamacare Affect American Indians and the Indian Health Service
Steve Beleu, Regional Depository Library for Federal Govt. Information, Oklahoma Dept. of Libraries

This is a summary on how the Patient Protection and Affordable Care Act, Public Law 111-148, more popularly known as Obamacare, will affect the Indian Health Service and the healthcare of American Indians. It has been taken from a speech by IHS Acting Director Dr.Yvette Roubideaux dated August 13, 2013 titled “Indian Health Service Update” and also from information on the IHS website. Here are the sources of this summary –
http://www.ihs.gov/newsroom/includes/themes/newihstheme/display_objects/documents/2013_Speeches/IndianHealthPartnershipsAugust32013.pdf
IHS homepage - www.ihs.gov

Regardless of the expansion of healthcare to all Americans through Obamacare the Indian Health Service (IHS) will continue to serve the enrolled members of American Indian tribes as they always have. Obamacare should bring more money into IHS’ budget. If nothing else that part of the Affordable Care Act that made the IHS’ authorizing legislation permanent, the Indian Healthcare Improvement Act, is important.

The benefits that IHS’ current patients have –

· 38% have Medicaid benefits

· 30% have only IHS benefits

· 23% have private insurance

· 10% have Medicare and VA benefits
(the total rounds up to 101% because of rounding up)

In states that accepted expanded Medicaid coverage more IHS patients will be able to apply for Medicaid benefits.

American Indians and Alaska Natives (AIAN) who are enrolled members of tribes won’t have copays or deductibles if they use IHS facilities or tribal health facilities funded by IHS. If they go elsewhere, and their income is below a certain level, they also won’t have copays or deductibles.

With the tax credits that are available AIAN may be able to pay very little in insurance premiums.

AIAN will have the option to enroll in Obamacare on a monthly basis, not just during the one enrollment period of each year that everyone else must use.

AIAN will not have to pay a penalty for not having insurance coverage.

But what about the definition of “Indian” in Obamacare? Currently only enrolled tribal members can receive Obamacare benefits. But the IHS will continue to provide services not only to tribal members but also to the unenrolled descendants of tribal members. Only Congress can amend the Affordable Care Act; this problem of definition can’t be fixed by the regulatory process.

Here are some Obamacare websites –
Obamacare website operated by the Centers for Medicare and Medicaid Services - www.healthcare.gov
CMS’ Health Insurance Marketplace - http://marketplace.cms.gov
National Indian Outreach and Education Initiative – http://tribalhealthcare.org
Four guides for AIAN from marketplace.cms.gov –
http://marketplace.cms.gov/getofficialresources/publications-and-articles/american-indian-and-alaska-native-publications.html

September 26, 2013