The Affordable Care Act & You

Ensuring your family has met the requirements of the Affordable Care Act can be overwhelming. ANTHC provides this overview to help you better understand the law and what you need to do. This information has been recently updated to keep Alaska Native and American Indian people informed of the law and their rights.


What is the
Affordable Care Act?

Alaska Native and American Indian people have special protections and benefits when it comes to the Affordable Care Act (ACA).

Exemption from the requirement to have health care coverage:


The ACA requires 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." Alaska Native and American Indian people are exempt from this requirement, but, you must apply for this exemption. For more information on how to get the exemption for you and your family, please click here.

One of the most important things for Alaska Native and American Indian people to know about the ACA is, even if you donít buy insurance, you and your family will still be able to get health care services at your Tribal health facility. The health care services provided at IHS/Tribal health facilities are not changing.

Special Benefits for Alaska Native and American Indian people who want to purchase health care coverage:


There are special benefits in the ACA for Alaska Native and American Indian people who choose to purchase health care coverage. For instance, a family of four with income up to $89,460 who purchases coverage at www.healthcare.gov, wonít have to pay out-of-pocket costs like deductibles, copayments, and coinsurance even if you donít get your care at a Tribal health facility. The federal government pays those costs for you. And, no matter how much you earn, if you purchase a plan at healthcare.gov, the federal government will always pay these costs when you are seen or referred by Tribal Health facilities.

We have heard from many Alaska Native and American Indian people who are interested in health care coverage for different reasons:

  • People who donít live near a Tribal health facility,
  • People who travel away from their Tribal health facility,
  • Parents with children going to school out-of-state, or
  • People who want more health care options

For lots of reasons, Alaska Native and American Indian people may want to know more about these special benefits. And, you can use this and all other types of health care coverage -- Medicaid, Veteranís Benefits, Denali KidCare, Medicare or insurance provided by your employer -- at Tribal health facilities. Your local Tribal health facility can bill insurance to help build an even stronger Tribal health system for generations to come.

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.

New Recommendation on the Indian Exemption

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 a Tribal health clinic or IHS Facility.

Previously, only members of federally recognized Tribes and shareholders of ANCSA corporations had the option to apply for the Indian Exemption when filing their taxes.

A recent announcement from the federal government allows descendants, people with a Certificate of Indian Blood (CIB) and those who are eligible for services through a Tribal health care provider will now be able to claim the Indian Exemption when filing their taxes.

The ANTHC Health Reform Team recommends claiming the Indian Exemption when you file your taxes.

IRS Tax Form 8965, titled "Health Coverage Exemptions," can be used to claim the Indian Exemption. E-mail the ANTHC Health Reform Team (healthreform@anthc.org) to get on the email distribution list to receive the IRS Tax Form 8965 when it is finalized by the IRS.

Frequently asked questions about the Indian Exemption:


Q: What if I already received a response with my Exemption Certificate Number?
A: Keep the letter with the Exemption Certificate Number (ECN) for you and/or your family in a safe place. You will need to report this number on your taxes. When filing taxes, you will report an exemption certificate number on IRS Tax Form 8965, titled "Health Coverage Exemptions." The form isn't final yet, but it will be ready by tax time.

Q: What if I sent in my exemption application but haven't heard anything on it yet?
A: Keep a look out for a letter from the "Health Insurance Marketplace." It could still arrive. If you don't receive a letter with an Exemption Certificate Number, you can claim the Indian Exemption on IRS Tax Form 8965, titled "Health Coverage Exemptions," with your taxes. The form isn't final yet, but it will be ready by tax time.

Q: What if I lost the letter with my Exemption Certificate Number?
A: If you received your Exemption Certificate Number in the mail and misplaced the letter, you can claim the Indian Exemption on IRS Tax Form 8965, titled "Health Coverage Exemptions," with your taxes. The form isn't final yet, but it will be ready by tax time.


Tribally-Sponsored Health Insurance

Tribes and Tribal health organizations may now pay for health insurance for Alaska Native and American Indian people who qualify. The Alaska Tribal Health System is offering Tribally-Sponsored Health Insurance in Alaska on a limited trial basis. This sponsorship is a collaboration of tribes and Tribal organizations whose Board of Directors have committed funding for the project.

For more information on Tribally-Sponsored Health Insurance, click here.

What if I need help or have questions?

Email: healthreform@anthc.org
Phone: 907-729-7777

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

Find a resource near you: https://localhelp.healthcare.gov


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

4000 Ambassador Drive
Anchorage, AK 99508