Health Reform Makes Tribal Enrollment Essential

Written By: Alaska Native Tribal Health Consortium & Southcentral Foundation

Beginning January 1, 2014, every American must demonstrate health care coverage under the Affordable Care Act (ACA). This means if you do not already have coverage (e.g., Medicaid, Medicare, Denali KidCare or private insurance) you will be required to purchase health insurance or face a penalty when filing your taxes. The tax penalty could be as much as $695 per adult and $347.50 per child.

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

a)     Enrollment in a federally recognized tribe, or

b)     Alaska Native Claims Settlement Act (ANCSA) shareholder status

Even with this exemption, Alaska Native and American Indian people may choose to purchase insurance. Alaskans will have a new option of purchasing health insurance through the federal marketplace as early as October 2013 for plan coverage effective January 1, 2014.

Some Alaskans will qualify for premium subsidies based on income. For instance, an individual earning up to $57,400, or a family of four earning up to $117,760, may receive financial assistance when purchasing insurance.

Frequently asked questions:

Q: How do I enroll in a Tribe?

A: Tribal enrollment rules are different for every Tribe. You are most likely to qualify for Tribal enrollment in the village where your family comes from. Contact your family’s Tribe(s) to learn about what is required for enrollment. Tribal addresses can be found at You may also contact the Alaska Regional Office Bureau of Indian Affairs at (800) 645-8465, option 1.

Q: Does my Certificate of Indian Blood (CIB), issued by the Bureau of Indian Affairs (BIA), count?

A: While the CIB is an important document, you will still need to show proof of tribal enrollment to qualify for the exemption from the tax penalty.

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 it’s important to contact the Tribe.

For more information on the ACA, please visit