Affordable Care Act

What is the Affordable Care Act?

Beginning January 1, 2014, every American must demonstrate health care coverage under the Affordable Care Act, but there are special exemptions that apply to Alaska Native and American Indian people. The landscape of health care insurance is changing quickly.

In March 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act (ACA), into law. The law makes preventive care more accessible and affordable for many Americans. While some provisions of the law have already taken effect, many more provisions will be implemented in the coming years.

One of the biggest pieces of the ACA is the requirement that most Americans have health care coverage. If you donít have health care coverage for you and your family, you could be assessed a tax penalty. You may have heard the term "Individual Mandate."

In 2014, Health Insurance Marketplaces will be a new way to find health coverage. On the Marketplaces, some people may be eligible for lower costs on monthly premiums and out-of-pocket costs (such as co-pays and deductibles) based on their income.

why income matters


What if I have insurance?

If any of the conditions above apply to me, then I have satisfied the "Individual Mandate" and do not need to purchase additional health care coverage to avoid the tax penalty.

FAQ's for American Indians and Alaska Natives

Q: Am I exempt because I'm American Indian or Alaska Native?
A: Alaska Native and American Indian people are exempt from the requirement to purchase insurance if they can show evidence of:

  • Enrollment in a federally recognized Tribe,
  • Alaska Native Claims Settlement Act (ANCSA) shareholder status (village or regional) or
  • Eligibility to receive services from an Indian Health Service (IHS) facility/Tribal health care provider.

To qualify for this exemption, Alaska Native and American Indian people will have to apply for the exemption through a paper application process. This paper application will be available in early 2014. There may be a requirement to send a copy of your Tribal enrollment card, Certificate of Indian Blood (CIB) card, or other supporting documents. Please do not send originals as they will not be returned to you.

Q: What if I already have health care coverage?
A: If you have health care coverage through Medicaid, Medicare, Denali KidCare, Veteranís Benefits or your employer provides health insurance, you have met the requirements of the Individual Mandate and do not need to purchase additional health care coverage to avoid the tax penalty.

Q: If I donít buy insurance, will I still be able to get health care services at my IHS/Tribal health facility?
Yes, you will still be able to receive care at your IHS/Tribal health facility. However, you still need to apply for an exemption. The application will be available in early 2014.

Q: If I donít buy insurance, will I still be able to get health care services at my IHS/Tribal health facility?
A: Yes, you will still be able to get care at your IHS/Tribal health facility. The health care services provided at IHS/Tribal health facilities are not changing.

Q: How do I enroll in a Tribe?
A: Tribal enrollment rules are different for every Tribe. Contact your familyís Tribe(s) to learn about what is required for enrollment. Tribal addresses can be found at You can also contact the Bureau of Indian Affairs, Alaska Regional Office, at (800) 645-8465, option 1.

Q: Does it have to be a card or can it be a letter?
A: The Tribe may choose to issue an enrollment card or provide a letter that verifies Tribal status.

Q: Do I have to establish blood quantum?
A: Some Tribes may require a minimum blood quantum, so itís important to contact the Tribe.

"New Path to Health Care" video created by CMS Division of Tribal Affairs for tribal communities and tribal clinic waiting rooms to provide an overview of the Affordable Care Act and the American Indian and Alaska Native specific provisions.


Where do I buy insurance?

  • Visit to enroll on-line and to find more information
  • Shop for, compare and purchase insurance
  • Coverage starts as early as January 1, 2014
  • Also screens you for Medicaid and MIChild
  • See if you are eligible for a subsidy to reduce your monthly premium costs
  • Call 800-318-2596 Ė Call 24 hours day, 7 days a week (TTY: 1-855-889-4325)


What if I need help or have questions?

AIHFS is a Navigator Organization and here to assist. You can schedule a one-on-one appointment with an AIHFS Navigator.

What you will need to bring or have before the visit:

  • An email address. We can help you set this up if needed.
  • Your social security number or immigration document number
  • Estimated 2014 household income
  • Any information about current insurance.

AIHFS Navigators
Phone: 313-846-6030

There are also Certified Application Counselors and Brokers/Agents available to assist.

Find a resource near you:


     roadmap to health


Click on any video below to begin playing that segment of a 10-part video series from the Centers For Medicare & Medicaid Services(CMS) that supports the infographic above.






















Additional Resources


Healthy Michigan Plan Info

Click here to go to our Healthy Michigan Plan webpage

Bookmark and Share Follow us on: FaceBook twitter youtube LinkedIn Keep Pushing