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The Affordable Care Act & You

Beginning January 1, 2014, every American must demonstrate health care coverage under the Affordable Care Act, but there are special exemptions that apply to Alaska Native and American Indian people. The landscape of health care insurance is changing quickly. Here is what Alaska Native and American Indian people around Alaska need to know.


What is the
Affordable Care Act?

In March 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act (ACA), into law. The law makes preventive care more accessible and affordable for many Americans. While some provisions of the law have already taken effect, many more provisions will be implemented in the coming years.

One of the biggest pieces of the ACA is the requirement that most Americans have health care coverage. If you donít have health care coverage for you and your family, you could be assessed a tax penalty. You may have heard the term "Individual Mandate."

Health Insurance Marketplaces are a new way to find health coverage. On the Marketplace, some people may be eligible for lower costs on monthly premiums and out-of-pocket costs (such as co-pays and deductibles) based on their income. Alaskans can shop on the federal marketplace at

What if I have insurance?

If any of the conditions above apply to me, then I have satisfied the "Individual Mandate" and do not need to purchase additional health care coverage to avoid the tax penalty.


The Affordable Care Act and Alaska Native People

Alaska Native and American Indian people are exempt from the requirement to purchase insurance if they can show evidence of:

  • Enrollment in a federally recognized Tribe,
  • Alaska Native Claims Settlement Act (ANCSA) shareholder status (village or regional) or
  • Eligibility to receive services from an Indian Health Service (IHS) facility/Tribal health care provider

 Q: How do I qualify for the Alaska Native and American Indian exemption?
A: To qualify for this exemption, Alaska Native and American Indian people will have to apply for the exemption through a paper application process. This paper application can be printed at

When you complete the application, you must send copies of supporting documents, such as:

Preferred documents:

  • Tribal enrollment card/letter
  • Proof of ANCSA Shareholder Status (Regional or Village)

Other accepted documents:

  • Certificate of Indian Blood (CIB) card issued by the Bureau of Indian Affairs (BIA)
  • IHS Eligibility Letter

Please do not send originals of these documents as they will not be returned to you.

Please remember to complete Step 2 of the application for all members of your family, including children. Also, be sure to send copies of supporting documents for every member of your family that needs the Indian Status Exemption to avoid a tax penalty.

Within 2-4 weeks of mailing the form you will be sent an Exemption Certificate Number that you will put on your federal income tax return. It is important to keep a copy of this Exemption Certificate Number in a safe place for future use as the Indian Exemption is a lifetime exemption. If you do not hear from the Federal Government within 4-6 weeks, contact the Health Insurance Marketplace Help Center at 1-800-318-2596.

For assistance with the Indian Exemption Status paperwork and to learn more information about the ACA in Alaska, visit your local Tribal clinic or contact the ANTHC Health Reform group at, (907) 729-7777 or (855) 882-6842.

Frequently asked questions about the ACA:

Q: What if I already have health care coverage?
A: If you have health care coverage through Medicaid, Medicare, Denali KidCare, Veteranís Benefits or your employer provides health insurance, you have met the requirements of the Individual Mandate and do not need to purchase additional health care coverage to avoid the tax penalty. You do not need to complete the Indian Status Exemption paperwork if you have health care coverage. However, the Indian Exemption is a lifetime exemption and can be used anytime you have a gap in health care coverage.

Q: If I don’t buy insurance, will I still be able to get health care services at my IHS/Tribal health facility?
Yes, you will still be able to get care at your IHS/Tribal health facility. The health care services provided at IHS/Tribal health facilities are not changing. However, you will need to apply for an exemption to avoid a tax penalty.

Q: How do I enroll in a Tribe?
A: Tribal enrollment rules are different for every Tribe. Contact your familyís Tribe(s) to learn about what is required for enrollment. Tribal addresses can be found at You can also contact the Bureau of Indian Affairs, Alaska Regional Office, at (800) 645-8465, option 1.

Q: Does it have to be a card or can it be a letter?
A: The Tribe may choose to issue an enrollment card or provide a letter that verifies Tribal status.

Q: Do I have to establish blood quantum?
A: Some Tribes may require a minimum blood quantum, so itís important to contact the Tribe.


Tribally-Sponsored Health Insurance


Where do I buy insurance?

  • Visit to enroll on-line and to find more information
    • Shop for, compare and purchase insurance
    • Also screens you for Medicaid and Denali KidCare
    • See if you are eligible for a subsidy to reduce your monthly premium costs
  • Call 800-318-2596 Ė Call 24 hours day, 7 days a week (TTY: 1-855-889-4325)


What if I need help or have questions?

Phone: 907-729-7777

Navigators, Certified Application Counselors and Brokers/Agents are also available to assist.

Find a resource near you:


Alaska Native Tribal Health Consortium | ANTHC
(907) 563-2662

4000 Ambassador Drive
Anchorage, AK 99508