Health care reform law includes limited definition of 'Indian'

Monday, May 13, 2013  

The Affordable Care Act requires all Americans to obtain health insurance but a key provision exempts American Indians and Alaska Natives who receive care through the Indian Health Service.

But not all American Indians and Alaska Natives meet the definition of "Indian" in the law. That means they will have to pay a $695 penalty to the Internal Revenue Service if they don't obtain health insurance.

"I'm no less Indian than I was yesterday, and just because the definition of who is Indian got changed in the law doesn't mean that it's fair for people to be penalized," Liz DeRouen, who was recently disenrolled from the Dry Creek Rancheria Band of Pomo Indians in California, told the Associated Press.

The definition of "Indian" in the section of the law that deals with the insurance exemption appears to be the same as the one in 25 USC § 450b. That means only members of federally recognized tribes and shareholders in Alaska Native regional or village corporations are considered "Indian."

But that definition is narrower than the one found in the Indian Health Care Improvement Act, which was made permanent by the ACA. For example, California Indians with allotments have long been considered eligible for IHS care.

California Indians, or their descendants, who received assets as part of the 1958 termination law are also considered eligible. Under the ACA, however, some 21,000 California Indians could be shut out, according to the California Rural Indian Health Board.

Alaska Natives who are unable to join village or regional corporations are affected too. Nearly 47,000 could be forced to pay the penalty, according to the Alaska Native Tribal Health Consortium.

The IRS is holding a public hearing on May 29 in Washington, D.C.., to discuss rules for the exemptions in the ACA.

Get the Story:
Health reforms penalize some Indians, Native Alaskans (AP 5/13)

Federal Register Notice:
Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage (February 1, 2013)