The Affordable Care Act is Good For Native Americans


The sequester, a set of automatic spending cuts, has put Native American reservations in a serious bind when it comes to health care.

The overall funding reduction for reservations is approximately $386 million. The Indian Health Service (IHS), which is housed in the U.S. Department of Health and Human Services, provides care to enrolled tribal citizens who cannot afford other health care, and their service has been impacted the worst. The IHS has lost the funds to treat over 800,000 patients each year. These budget cuts will make it impossible to provide access and equitable health care for over 1.5 million Native Americans who are already living under the poverty line. 

As a working class woman of color, I know how frustrating paperwork, bureaucracy, and inadequate health care can be to navigate. Growing up on government-funded health care meant long waits, advice from inexperienced physicians, and losing hope in a system which seems doomed to fail. However, without insurance, people are more likely to have serious health complications related to delaying medical care or forgoing preventative care entirely. Recent reports show that a startling 45,000 people die each year due to lack of coverage. 

With the implementation of the Affordable Care Act (ACA), Native Americans who qualify for service from the IHS are exempt from the ACA regardless of official documentation of native ancestry. Earlier this year, the ACA had mandated a restriction that meant Native Americans had to provide documentation that proves their native ancestry to be recognized by the federal government to get the ACA exemption, which would have further complicated the already tedious system. Considering there are 100 tribes recognized by the state, but not the federal government, this change in the ACA is great news. It means Native Americans who chose not to participate in ACA and stay with the IHS will not have to pay a penalty. 

Does the ACA help fund clinics and hospitals in reservations? Absolutely!  The ACA permanently reauthorizes the Indian Health Care Improvement Act, which will strengthen health care for 1.9 million Native Americans. Additionally, Native communities have the option of applying to both services from the ACA and the IHS. Hopefully this will solve the crisis the IHS experienced resulting from extreme budget cuts from the sequester in March, and more people will have access to decent health care. 

With the implementation of the act, Americans are scrambling to understand how health care will impact their finances, and this is especially true for folks who already qualify for government insurance programs. Marginalized communities in the United States are often disproportionately impacted by legislation, which is why it is important to take a closer look at how the ACA will impact us. While the act is intended to solve the issue of providing health care to all Americans, Native Americans are having to wade through the limitations and budget cuts that could possibly afford them protection under the IHS and ACA. Clearly, the U.S. government has treaty obligations to provide health care to Native Americans and this is a great start.