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ACA and You

The Affordable Care Act, also known as the health care law, was created to expand access to affordable health care coverage to all Americans, lower costs and improve quality and care coordination. The health care law requires people to:

  • Maintain health insurance coverage that meets the minimum essential coverage requirement by January 1, 2014; or
  • Qualify for an exemption from the shared responsibility payment; or
  • Make a payment when filing their taxes if they have affordable options but remain uninsured.

If you have access to IHS health care benefits, you can continue to get your care from IHS, tribal, or urban Indian health programs (I/T/U). These services will always be available to you. However, if an I/T/U is your only source of care, you will need to:

  • Sign up for health insurance coverage, or
  • Claim an exemption from the individual shared responsibility requirement when you file a Federal tax return.*

*Please be aware that certain American Indian/Alaska Native protections available through the Health Insurance Marketplace only apply to members of federally recognized tribes. For more information, please visit: The Health Insurance Marketplace and AI/ANs Exit Disclaimer: You Are Leaving .

IHS and Health Insurance

If you have other forms of health care coverage, such as private insurance, Medicare, or Medicaid, CHIP, TRICARE, or VA Health Benefits, you can continue to use IHS and:

  • The services you receive at your local I/T/U health care facility will continue to be provided at no cost to you.
  • An I/T/U health care facility may be able to bill for services they provided to you.
  • You may be able to receive health care services unavailable at your I/T/U health care facility.

If you don't have access to affordable health insurance, you may be eligible for coverage at the Health Insurance Marketplace. For more information on where to find an I/T/U health care facility near you, please visit: Find I/T/U Health Care. To determine if you are eligible for IHS health care benefits, please visit our Frequently Asked Questions.

The Health Insurance Marketplace

The Health Insurance Marketplace is a new way to shop for and purchase private health insurance that fits your budget and meets your needs. People who purchase insurance through the Marketplace may be able to lower the costs of health insurance coverage by paying lower monthly premiums. For more information, please visit

Shared Responsibility Requirement Exemption

If you are an enrolled member of federally recognized tribes or are otherwise eligible for services through an Indian health care provider or the Indian Health Service you may claim an exemption to the shared responsibility payment. If you do not have access to an Indian health care provider, you may be eligible for other exemptions available through the Health Insurance Marketplace. These exemptions are based on certain qualifications, including:

  • Various hardships, including lack of affordable coverage based on projected income
  • Lack of insurance coverage for less than three consecutive months between months of coverage
  • Lack of affordable coverage based on actual income
  • Having income below the tax filing threshold
  • Unlawful presence in the U.S.
  • Membership in a health care sharing ministry
  • Membership in a recognized religious sect objecting to health coverage
  • Incarceration status, except pending disposition of charges