Medicaid Coverage and Access to Care for American Indians and Alaska Natives Under the Affordable Care Act

In this issue of JAMA Internal Medicine, Frean and colleagues¹ find Medicaid coverage gains among American Indians and Alaska Natives (AIANs) in states that expanded Medicaid under the Affordable Care Act (ACA) Medicaid expansion. They also find that, among AIANs living near reservations, most gaining Medicaid utilize Indian Health Services (IHS) for care. These findings suggest important strides forward for the 5 million individuals who self-identify as AIAN. American Indians and Alaska Natives confront persistent disparities in health and health care. They have a high uninsured rate, face significant barriers to obtaining care, and have substantial health needs, including high rates of obesity, diabetes, and suicide.² Medicaid coverage gains will increase their access to care and enhance capacity among IHS and Tribal health care providers.