Affordable Care Act and Implications for Alaska Natives

As of January 2014, according to the federal Affordable Care Act, individuals must have health coverage or may be liable to pay a tax penalty. In some cases, American Indians / Alaska Natives and other individuals who are eligible to receive services from an Indian Health Care Provider, may be able to receive an exemption from this fee if they can show:

  • Proof of ANCSA Shareholder Status (Regional or Village)

  • Tribal enrollment card/letter

  • Certificate of Indian Blood (CIB) card issued by the Bureau of Indian Affairs (BIA)

  • IHS Eligibility Letter

Screen Shot 2014-04-21 at 10.54.38 AMTo qualify for this exemption, an application must be submitted. This application can be found at www.anthctoday.org/aca or you can visit your local health clinic.

Copies of supporting documents must also be included with your application. Do not send originals, they won’t be returned. 

Be sure to complete Step 2 of the application for each member of the family for whom you are applying. Include their supporting documentation as well. Included in the application is the mailing address for submission. It can take 4-6 weeks to receive a response. 

What is the penalty if I don’t have health coverage and do not apply for the exemption?
For 2014 the penalties are $95.00 per adult and $47.50 per child, up to $285.00 maximum per family. The fees increase to $695 per adult and $347.50 per child in 2016.

Will I still be able to get health care services at my IHS/Tribal health facility?
Yes. The health care services provide at IHS/Tribal health facilities are not changing.

What if I already have health coverage?
If you have health care coverage through your state, government or employer, you have met the requirements of the Individual Mandate and do not need to purchase insurance through the marketplace. If you are eligible or already a carrier for Medicaid, Medicare, and Denali Kid Care you are strongly encouraged to apply or reapply. We can assist with re- newing and applying for them as it enhances the services you receive and can pay for services your tribal health clinic cannot provide. You can have the exemption and still be eligible for coverage. It is still policy to apply for Medicaid or Denali Kid Care when utilizing contract health services dollars or provide proof of ineligibility.

Do I have to apply for the exemption every year?
No. If you qualify for the exemption you can keep it for future years without submitting another application, as long as your membership or eligibility for services from an Indian Health Care Provider remains unchanged.

The Alaska Native Tribal Health consortium has created an informative site which answers questions and offers more information about exemptions and market place insurance. Please visit http://anthctoday.org/aca/index.html for more information. You can also contact the ANTHC Health Reform group at healthreform@anthc.org, (907) 729-7777 or (855) 882-6842.

You can also pick up exemption forms or request assistance at one of the Chugachmiut Health Services clinics.