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The Affordable Care Act and the Indian Health Service

The Patient Protection and Affordable Care Act (ACA), also known as Obamacare, or the health care law, was created to expand access to coverage, control health care costs, and improve health care quality and coordination.

The ACA also includes permanent reauthorization of the Indian Health Care Improvement Act, which extends current law and authorizes new programs and services within the Indian Health Service.

American Indians and Alaska Natives may receive health insurance from his or her employer, purchase insurance from an insurance company, enroll in Medicare, Medicaid, or Healthy Montana Kids, or receive health services provided by an Indian Health Service, tribal (CSKT Tribal Health and Human Services), or urban clinic.

As an American Indian and Alaska Native individual, you may continue to access health care from the Indian Health Service or your Tribal (THHS) clinic. The Affordable Care Act offers you new choices and opportunities for Insurance. This insurance coverage will pay your local IHS or Tribal facility for healthcare that is provided to you. Increased funding helps our communities and our IHS and Tribal facilities to provide increased and better care.

The ACA and American Indians and Alaska Natives
For American Indians and Alaska Natives, the ACA will help address health disparities by investing in prevention and wellness and increasing access to affordable health coverage.

The ACA provides American Indians and Alaska Natives with more choices; depending on your eligibility and the coverage available in your state, you can:
   • Continue to use Indian Health Service, tribal (CSKT Tribal Health and Human Services), and/or urban Indian health programs,
   • Enroll in a qualified health plan (QHP) through the Health Insurance Marketplace, and/or,
   • Access coverage through Medicare, Medicaid, and the Children’s Health Insurance Program, or Montana Healthy Kids.

If you choose to enroll in a QHP through the Health Insurance Marketplace plan, you may qualify for special benefits and protections offered to American Indians and Alaska Natives.

Three Things You Should Know
    • Indian Health Service will continue to provide quality, culturally appropriate services to eligible American Indians and Alaska Natives.
    • Under the ACA (Obamacare), everyone is required to maintain minimum essential coverage or pay a fee, known as the “shared responsibility payment.”

Being eligible for IHS services alone does not meet the minimum essential coverage requirement.
       - If you do not have health insurance coverage and receive care from IHS, you will need to either:
      * Sign up for health insurance coverage,
      * Pay the shared responsibility payment, or
      * Apply for an exemption.
      - If you have health insurance coverage from your employer that meets the minimum essential coverage requirement, or have other health care coverage — through Medicare, Medicaid, HMK, VA Health Benefits, or TRICARE — you are covered and don’t need to worry about paying the shared responsibility payment or enrolling for health coverage available through the Health Insurance Marketplace.
      - If you are offered and decline health insurance coverage — that meets the minimum essential coverage requirement — from your employer — you must pay the shared responsibility payment or obtain an exemption, if eligible.

Members of federally recognized tribes and other individuals who are eligible to receive services from Indian health care providers will have access to a special exemption, but other exemptions are available.
       - If you are not offered health insurance coverage through your employer or are unemployed, you may be eligible for coverage through the Health Insurance Marketplace.

To learn more about health insurance options or if you are interested in applying for an exemption, please visit website: www.healthcare.gov
    • American Indians and Alaska Natives have access to affordable health care coverage options through the Health Insurance Marketplace. You may now be eligible to purchase insurance coverage or determine if you qualify to enroll in Medicaid.

If you qualify for and enroll in a plan through the Health Insurance Marketplace, you may be eligible for premium tax credit assistance — based on your income, and/or, cost sharing waivers — based on being a member of a federally recognized tribe.

To find out what you’re eligible for, please visit and fill out an application on website: www.healthcare.gov

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