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Begich, Baucus, Udall, Schatz, Franken Introduce Important ‘Fix’ to Affordable Care Act


Bill Will Provide Clarification for Thousands of Alaska Natives / American Indians

U.S. Sens. Mark Begich (D-AK), Max Baucus (D-MT), Tom Udall (D-NM), Brian Schatz (D-HI), Al Franken (D-MN) co-sponsored legislation today to correct an inconsistency in the Affordable Care Act (ACA), which without a permanent fix could prevent health care benefits for thousands of Alaska Natives and American Indians nationwide.  

The current version of the health care law contains several important provisions for Native Americans including permanent reauthorization of the Indian Health Care Improvement Act.  However, the health care law contains several different definitions of “Indian” which led to conflicting interpretations of eligibility for benefits and requirements for coverage.  The new legislation adds new and comprehensive definitions that are outlined in the attached bill. 

“I’ve said many times that the Affordable Care Act has flaws that need to be addressed and this is just one more way we can improve the law and ensure even more Alaskans have access to quality medical care,” said Senator Begich.  “I have heard from Alaska Tribal Health organizations for months about the urgent need to introduce legislation that will serve as a technical fix within the ACA to broaden the definition of Indian as applied to Alaska Natives.  I see this bill as part of our duty to ensure that our tribes and tribal health organizations can best serve and offer health care to all of those who are intended to benefit from the Affordable Care Act, and as part of the federal government’s trust responsibility to the First Peoples of this country.”

“The Health disparities faced by American Indians, Alaska Natives and Native Hawaiians are appalling and must be addressed at every opportunity,” said Senator Schatz.   “That is why I have joined Senate colleagues in introducing this measure of vital importance to American Indians and Alaska Natives eligible for Indian Health Service programs and services.  This bill will provide a number of technical corrections to clarify provisions under the Affordable Care Act to ensure that the definition of ‘Indian’ will be consistent with the eligibility rules of the IHS and Medicaid and moves us in the right direction. I urge Congress to act expeditiously to adopt this measure.”

In Alaska, it has been estimated that up to 14,000 Alaska Native people are not enrolled in Alaska Native Corporations and also not enrolled in a tribal government. These individuals have historically been eligible for IHS benefits, and will continue to be. However the issues at stake are the IRS tax penalties for not carrying coverage, cost sharing provisions, and special enrollment periods.  The proposed legislation will change the definition of Indian within the Affordable Care Act to include all Alaska Natives who are eligible to receive healthcare under existing law, which would allow the estimated 14,000 receive fair treatment under the law. 

"On behalf of those served by the Alaska Native Tribal Health Consortium and most especially those who would be harmed from this unintended and narrowly interpreted oversight, we applaud Senator Begich for his proactive stewardship in sponsoring legislation which ensures that Alaska Native people will receive the intended benefits of health reform and the Affordable Care Act," said Andy Teuber, Alaska Native Tribal Health Consortium Chairman and President.

This issue had been identified as a problem since 2010 when the legislation was enacted and released to the public. Since then the Health and Human Services Administration has issued what’s known as a hardship waiver to help streamline the definition of Indian in the ACA, to avoid tax penalties for Native American’s who do not carry insurance.  However, regulatory statues tend to fluctuate over time and Administrative action, however helpful was not a full and permanent fix. 

Additional information is available in the attached FAQ sheet.

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