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Obamacare to penalize nearly half a million Native Americans

Published time: May 15, 2013 20:43
Reuters / Rebecca Cook

Reuters / Rebecca Cook

Native Americans are entitled to free and subsidized medical care at some federally-funded health clinics, but 'Obamacare' will soon force many of them to buy insurance or else face hefty fines if they are not “Indian enough”.

“A lot of folks are going to get stuck with the bill,” Jay Stiener of the National Council of Urban Indian Health told the Associated Press.

Members of federally-recognized American Indian tribes have received government-funded health services since 1787. Throughout the US, there are 33 hospitals and 59 health centers that provide services including prenatal care, baby well-checks, dentistry and eye glasses to Native Americans.

The US government has treaty obligations to care for the well-being of Native Americans, but may soon abandon many of its legal responsibilities. President Obama’s health care reform will force thousands of Native Americans to purchase their own health insurance or pay a minimum fine of $695 to the Internal Revenue Service. Indian health advocacy groups estimate up to 480,000 people will be affected, AP reports.

Only those who can prove that they are “Indian enough” will be exempt from the mandate. Native Americans will have to show documentation that they belong to one out of 560 tribes that are federally recognized by the US Bureau of Indian Affairs.

There are more than 100 US tribes that are recognized by states, but not the federal government. Members of these tribes would no longer receive the free or subsidized healthcare that they are guaranteed by the Indian Health Service (IHS), which is a division within the US Department of Health and Human Services.

“This could lead to some tribal citizens being required to purchase insurance or face penalties even though they are covered by the HIS,” Rep. Tom Cole, a Republican congressman and member of the Chickasaw Nation tribe, told AP.

Additionally, Native Americans who do not have documentation of their tribe membership will be forced to purchase insurance or pay a fine. This becomes particularly troublesome for Native Americans under the age of 18, since many tribes only provide official membership to adults. Even if both parents of the minors are members, their healthcare coverage may not apply to their children unless they also have the proper documentation. 

The health care reform would also complicate the situation for Native Americans who live in metropolitan areas or suburbs. Some tribal governments require members to live on the reservation to gain documentation, which few people do. Nearly two-thirds of American Indians and Alaska Natives currently live in cities, which hinders their ability to receive membership cards from their tribes. 

News of the restrictions that Obamacare will impose upon American Indians has sparked outrage, particularly among those who will face financial consequences due to something that is out of their control.

“I’m no less Indian than I was yesterday, and just because the definition of who is Indian got changed in the law doesn’t mean that it’s fair for people to be penalized,” Liz DeRouen, a Native American who usually receives healthcare at a government-funded clinic in North Carolina, told AP. “If I suddenly have to pay for my own health insurance to avoid the fine, I won’t be able to afford it.”

DeRouen is a former tribal administrator for the Dry Creek Rancheria Band of Pomo Indians, but she lost her membership due to an argument with other members. But even though she lost documentation as a tribe member, she is still genetically considered a Native American.

The Obama administration currently has no solution to the hardships the Affordable Care Act will inflict upon the Native American population, but the IRS and the US Treasury have jointly scheduled a public hearing forMay 29to discuss establishment of who qualifies for the exemption from the insurance coverage requirement.

Nearly 30 percent of all Native Americans live below the poverty line, and forcing them to pay fines or purchase insurance would likely just increase this number.

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