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The historic health reform law, known as the Affordable Care Act (ACA), moves our nation toward a health care system that covers many more people. The benefits and protections the new law provides are critical to promoting health equity among communities of color. As the law moves toward eliminating disparities, many American Indian and Alaska Natives stand to gain from its health reform provisions.

The new health reform law will significantly expand access to affordable health coverage, which is especially important for all members of federally recognized tribes. Nationwide, over 29 percent of Native Americans were found to be uninsured. Depending on where members of the Sault Ste Marie Tribe of Chippewa Indians live, recent data has shown that as many as 50-60 percent are uninsured.

Even though Sault Tribe members are able to access the tribe’s health care delivery system across the Upper Peninsula at no cost, many services cannot be provided due to a lack of or a reduction in federal Indian Health Service funding. According to Families USA’s Minority Health Initiatives (September 2012), health reform will expand coverage to American Indians for health care services by doing the following:

Expanding Medicaid

Under the new law, Medicaid coverage will be expanded to cover children and adults with incomes up to 133 percent of the federal poverty level—roughly $15, 281 for an individual and, for a family of three, $25,974. Over 277,800 non-elderly American Indians and Alaska Natives across the nation will be newly eligible for Medicaid. This Medicaid expansion, which will go into effect in 2014, will provide coverage to many tribal members who would otherwise go without quality, affordable health coverage, particularly adults without dependent children.

Creating new marketplaces

For individuals who do not qualify for Medicaid, the new law will expand coverage through the creation of state health exchanges. Beginning October 2013, these exchanges will allow individuals to shop for insurance and easily compare prices and benefits. To ensure that health insurance is affordable, the law will provide refundable tax credits to offset a portion of the cost of health insurance premiums.

These historic coverage expansions should have a significant impact on American Indians and Alaska Natives with low or moderate incomes.In addition, the new law offers critical protections to all individuals by eliminating discrimination due to pre-existing health conditions. According to a recent report by Families USA, more that one-quarter of Native Americans (25.9 percent) have a condition (such as cancer or obesity) that, without health reform, could lead to a denial of coverage.

Through the expansion of the state Medicaid program or through state health exchanges, the Sault Ste. Marie Tribe of Chippewa Indian’s Health Division staff are now prepared to assist tribal members to sign up for health insurance coverage. Even though members of federally recognized tribes are exempt from participating in the health care law, more insured tribal members means more resources would become available to provide health care services. This also means that more services could become available at the Tribal Health Centers and, if needed, for specialty care outside of the tribal health care delivery system. More insured tribal members will allow the tribe to improve all health care services but, most important of all, would help to ensure that all Native American families are able to live healthy and productive lives.

Members of the Sault Ste. Marie Tribe of Chippewa Indians and other federally recognized Tribes are encouraged to call the Tribal Health Center nearest you or check out: “Quick guide to health insurance with federal funding,” "10 questions about health exchanges," and “What tribal members need to know about health insurance exchanges.”

Sault Ste. Marie Tribal Health Center—(906) 632-5200

Hessel Tribal Community Health Center—(906) 484-2727

St Ignace Tribal Health Center—(906) 643-8689

Newberry Tribal Community Health Center—(906) 293-8181

Manistique Tribal Health Center—(906) 341-8469

Munising Tribal Health Center—(906) 387-4721

Escanaba Tribal Community Health Center—(906) 786-2636