As part of the Affordable Care Act (ACA), Medicaid coverage could be expanded to cover nearly 400,000 currently uninsured American Indians and Alaska Natives (AI/AN). This population, particularly sensitive to health disparities, suffers from elevated disease burdens and poorer overall health than that of the general population. The AI/AN population consequently has a shorter life expectancy.

The Center for Health Care Strategies explored the implications of ACA provisions aimed at addressing racial and ethnic health care quality and access disparities as they affect the AI/AN populations. Results were published in a seven-page policy brief, Implications of Health Reform for American Indian and Alaska Native Populations.

This brief highlights specific provisions that affect the AI/AN population; opportunities presented by the ACA to improve access, quality, and outcomes; and strategies that stakeholders and states may use to optimize ACA potential for this population.

The brief looked at the following areas:

  1. AI/AN health insurance coverage and coverage expansion including new approaches to ensure the greatest benefits.
  2. Specific actions states can take to increase tribal engagement including: the development of a plan of action addressing health disparities; sanctioning use of coverage benefits at urban Indian organizations already providing care to AI/AN populations; and outreach and enrollment strategies.
  3. Care financing and opportunities to fill organization gaps.

Authors discuss Federal and state-operated Health Insurance Exchanges (the new ACA-mandatedinsurance product marketplaces), AI/AN tribal exchange navigators charged with delivering linguistically and culturally appropriate outreach and information, Medicaid eligibility, grant opportunities, provider responsibilities and reimbursement, and the Indian Health Care Improvement Act (IHCIA) reauthorization.

The study concluded that collaboration was required among states and tribes to maximize opportunity, minimize the administrative burden, and foster cultural relevance.

To read or download the full brief, click here (PDF).