Did you know? Native Americans and the Insurance Marketplace

The health insurance landscape for Native Americans (NAs) and Tribal citizens is complex and multifaceted. While many rely solely on tribal or Indian Health Service (IHS) for healthcare, there are alternative options that may provide more autonomy and potentially more affordable care. This article explores the health insurance marketplace for Native People and how it can be a viable alternative.

Tribal/IHS Care vs. Marketplace Insurance

Traditionally, enrolled tribal members have relied on the tribe or IHS for healthcare. While this comes at no cost to the tribal member, it often means losing virtually all control over health outcomes. 

Your Tribal Nation/IHS picks the providers, specialists, and whether the care is necessary. They can even deny care based on funding constraints, and the process to get non-tribal/IHS care approved can be lengthy.

On the other hand, marketplace insurance could provide more control and flexibility. It may also be more affordable than a health plan offered at work. 

Insurance Coverage: In 2019, 51.9 percent of American Indians and Alaska Natives alone or in combination had private health insurance coverage. 42.1 percent of AI/ANs relied on Medicaid or public health insurance coverage, and 14.9 percent of AI/ANs had no health insurance coverage. This compares to non-Hispanic whites by 74.7 percent, 34.3 percent, and 6.3 percent respectively.

OMH-HHS

Affordable Care Act (ACA) Benefits for Native Americans

The ACA has specific provisions for American Indians and Alaska Natives. According to the Administration for Children and Families, these provisions include:

• No Cost for Copay, Deductible, or Coinsurance: For in-network providers and some plans, there is no cost for out-of-network as well.
• Premium Coverage: If a Native American enrolls in a marketplace plan via the tribe/IHS, the premium may be covered.
• Tax Credit Eligibility: If not registered via the tribe/IHS, Native Americans are eligible for a tax credit to cover the cost.

Promoting Personal Autonomy and Self-Sufficiency

Marketplace insurance promotes personal autonomy and ensures prompt healthcare. Unlike relying solely on the tribe/IHS, a tribal member can choose your providers, specialists, and type of care. 

Going to the ER or urgent care without going through contract health for reimbursement is possible. You can receive care sooner and closer to your location, depending on the location of the tribal/IHS facility.

In essence, being insured through the marketplace allows a Tribal Citizen to regain control over healthcare decisions. It promotes personal autonomy and self-sufficiency, as you are not relying solely on the tribe/IHS.

–

The health insurance marketplace offers a viable alternative for Native Americans seeking more control and potentially more affordable healthcare options. While tribal/IHS care has benefits, the marketplace provides a path toward personal autonomy and self-sufficiency. 

It’s a path that aligns with the values of sovereignty and preservation central to Native American communities.

For more information on enrolling in a marketplace plan and understanding the specific benefits available to you, consult with your tribal health department or visit the HealthCare.gov website designed for Native Americans and Alaska Natives.