ACA Exemptions and Benefits for American Indians and Alaska Natives

There have been a lot of questions about who qualifies for the ACA exemptions and benefits as an American Indian/Alaska Native. First of all let me tell you that it is very confusing because the definition of AI/AN in the Affordable Care Act does not meet the definition under Indian Health Services or Medicaid.

Here is what I can tell you:

1) If you are an AI/AN who is a member of a federally recognized tribe:

  • You are exempt from the individual mandate to purchase health insurance
  • You receive the full benefits including: Little to no-co pays/deductibles depending on your income and special open enrollment periods.

2) If you an AI/AN who is not a member of a federally recognized but are otherwise eligible to receive services from IHS including at urban clinics, like AIHFS:

  • You can apply for a hardship exemption through the marketplace (paper forms are currently in development)
  • You do not have access to the benefits such as copays/deductibles or the open enrollment periods.

Remember there are many other types of exemptions available as well, so do not hesitate to contact someone at AIHFS for further clarification or assistance.