By Brandon Ecoffey
Native Sun News
Managing Editor RAPID CITY—As America waits for members of congress to sort out their differences and thousands of Bureau of Indian Affairs and Indian Health Service workers continue to work without pay or are locked out of their jobs many in Indian country are asking, what is ObamaCare? The government shutdown has been centered on the failure of Congress to pass a budget with Republicans holding the country hostage by refusing to fund the Affordable Healthcare act better known as ObamaCare that was passed in to law in 2011. For Native people across the country, healthcare on reservations although severely underfunded, is provided for free by the federal government through the Indian Health Service. For some members of tribal nations who live in urban areas like Rapid City and Albuquerque, there are IHS hospitals available to them but the majority of these facilities are located on Reservations. The medical services that are provided to Indian country are a very small part of what the federal government is legally required to provide to Native people as a result of the historical relationship that exists between tribes and the federal government, treaties, and the trust relationship as determined by the Supreme Court. On the surface ObamaCare is essentially an overhaul of the nation’s healthcare system designed to lower prices on medical insurance and to provide a pathway for the poverty stricken and those who are already sick to acquire insurance. The law institutes several protections for these two groups of citizens and will require insurance providers to stop the practice of denying healthcare due to diseases that a person already has. The law will also force insurers to provide free preventive care, pay for routine checkups, and place caps on what an individual would have to pay out of pocket. One part of the law will require that everyone living in the country have some sort of healthcare coverage or pay a fine. This has been a contentious part of the law and one of the sticking points for Republicans. For those who choose to not buy insurance they will be forced to pay a fine, this is the individual mandate that politicians continue to talk about. For Native Americans who are eligible to receive services from IHS they will be exempt from this individual mandate. The eligibility of Native people for the exemption has been criticized by the less informed including FOX news who have said this is unfair to the rest of the Country. Tribal members still have to apply for the exemption however and there are two ways to do this, you can either claim these exemptions on your 2014 federal tax return of you can apply for them in the Health Insurance Marketplace. The fee for not choosing to purchase insurance for those who are not eligible for Indian Health Service will be 1percent of your yearly income or $95 per person for the year in 2014 and will increase every year with it being 2.5 percent in 2016 or $695 per person in 2016. There are several other groups of people who are exempt from the law and they are listed on the healthcare.gov website. Once fully implemented there will be four groups under which all Americans will fall in terms of their medical insurance. One in two Americans will be covered by their employer, one out of three will be covered under Medicare and Medicaid, one out of ten will still buy private insurance and less than 10 percent of the country will still be uninsured. Under the Affordable Care Act the eligibility requirements to qualify for Medicaide have been expanded to those whose income is less than 138 percent of the poverty level in their state. However this expansion will not be available in all states as a result of a Supreme Court ruling that allows individual states to opt out of this part of the law. South Dakota is one example where the poorest parts of the population will be denied Medicaid due to the decision of the Governor. For those that are employed at businesses who have more than 50 employees they will be covered through their work. Many may still have to pay in to their insurance but there will be caps on what they are required to pay. In all states there will be virtual Marketplaces places set up where you can shop and compare rates from competing insurance companies. For those who are not covered by your employer or who live in states that did not expand Medicaid the feds will be creating these marketplaces. For those who fall within 400 percent of the poverty level you will be eligible for tax incentives and vouchers based on your income once you are enrolled in ObamaCare. There are special incentives set up for Native Americans who are eligible for IHS services who buy private insurance. You will not have to pay out of pocket costs such as deductibles or copayments if your income falls in to certain ranges based upon the state you live in. If you do buy private insurance you will still be able to use IHS facilities and Urban Indian Health care facilities. To register for health insurance through the marketplace or to find more information on the Affordable Care Act you can log on to www.healthcare.gov. Copyright permission by Native Sun News
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