Native American Health Care Reform Guide

Jun 10, 2013

Native American Health Care Reform Guide UPDATED May2013 tnCon Alma Health Foundation is proud to release this updated guide outlining how Health Care Reform affects Native Americans. The Native American Health Care Reform Guide: Implications of Health Care Reform for Native Americans in New Mexico helps to understand the changes that will take place through Health Care Reform and helps people to maximize benefits from the specific provisions of the new law that apply to Native Americans. It assists individual Native Americans, Native communities, Tribal governments, the Indian Health Service, Tribal 638, and Urban Indian Health Programs to recognize the opportunities to expand and strengthen Indian health systems through implementation of Health Care Reform. The Native American Health Care Reform Guide outlines immediate and upcoming changes by population category, including for individuals with health insurance, children and young adults, people with pre-existing conditions, people on Medicare, small employers, people using Indian Health Service and tribal governments.

Roxane Bly, an American Indian health-policy consultant who wrote the guide for Con Alma Health Foundation, said it’s critical for American Indians to understand that even though they are not required to have health insurance, it’s important to get as many American Indians covered as possible through the health-insurance exchange or Medicaid expansion.

“The Indian Health Service is not health insurance,” she said. “It’s a fragile system where people can get some services, but it’s unreliable and underfunded. When Indian people have coverage, tribal providers can bill for those services and put money back into the system. It strengthens the Indian health system and could potentially allow for the expansion of services.”

Key information from the guide:

  • Employers with at least 50 full-time employees are required to offer minimum essential coverage that satisfies the individual mandate. Tribal governments are not exempt from this requirement.
  • American Indians enrolled in Medicaid cannot be required to share costs if they are eligible for IHS services or have used IHS in the past.
  • American Indians paying for insurance through the health-insurance exchange do not have to pay co-pays or deductibles if their income is less than 300 percent of the federal poverty level.
  • Right now health insurers can’t arbitrarily cancel your coverage if you get sick.
  • Insured people can now get preventive care, such as annual exams and cancer screenings, with no out-of-pocket costs.
  • Employers can receive a tax credit for up to 35 percent of what they spend on coverage for employees. This credit increases to 50 percent in 2014.

In addition to the health-care reform guide, Con Alma Health Foundation brought people together in four convenings to learn more about how the federal Affordable Health Care Act will affect them and the people they serve. Con Alma held meetings in Albuquerque, Las Cruces, Clovis, and Gallup so people from across the state had an opportunity to learn from one another and network.

“After holding meetings across the state, we’ve learned that people are hungry for information about how federal health-care reform will affect them,” said Dolores E. Roybal, Con Alma’s executive director. “We developed this guide as an easy way for people to learn how federal health-care reform will impact them.”

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