Research Letter
Health Care Reform
June 2016

Health Reform and Coverage Changes Among Native Americans

Author Affiliations
  • 1Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 2Partners HealthCare, Boston, Massachusetts
  • 3Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
  • 4Department of Medicine, Brigham & Women’s Hospital, Boston, Massachusetts

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Intern Med. 2016;176(6):858-860. doi:10.1001/jamainternmed.2016.1695

The Affordable Care Act (ACA) expands health insurance for Native Americans through Medicaid and Marketplace coverage, despite Native Americans being exempt from the law’s individual mandate. The ACA also permanently reauthorized the Indian Health Care Improvement Act, which funds the Indian Health Service (IHS). The IHS provides health care services to 2.2 million Native Americans annually but is not considered insurance by the US government.1 We evaluated changes in insurance and IHS coverage among Native Americans following the ACA’s implementation.

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