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 .
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 Marketplace provides an easy way to identify health insurance coverage, find out if you're eligible for health insurance at reduced or no cost, and compare qualified health programs. In the Marketplace, some people may be eligible for lower health premiums and out-of-pocket costs based on their income. The Marketplace offers a streamlined application process to help people understand what benefits are available and which protections may apply. The Marketplace makes it easier to find coverage by offering the following special protections for enrolled members of federally recognized tribes, including:
- Special monthly enrollment periods
- Cost-sharing exemptions
In order to determine if you qualify for special protections, you may be asked to provide additional documentation for tribal membership and household income. For more information, visit Healthcare.gov .
Shared Responsibility Requirement Exemption
American Indian and Alaska Native consumers who are enrolled members of federally recognized tribes or who are otherwise eligible for services through an Indian health care provider or the Indian Health Service may claim an exemption to the shared responsibility payment. The Exemption applies to those unable to maintain minimum essential coverage for any time during the year.
To receive an exemption, you must claim the exemption when filing federal income taxes using form 8965.
For more information about exemptions, please visit: Healthcare.gov/Exemptions .
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 Healthcare.gov
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
To determine eligibility for other exemptions, please visit Healthcare.gov/Exemptions .