Some Montana Native American tribal members say they are surprised they will have to abide by the Affordable Care Act (ACA) – and could face fines exceeding $1 million for not offering insurance to employees – although American Indians, by law, are typically exempt from such national regulations.
The law is such that American Indians, as individuals, can choose to follow the ACA rules. But tribal governments, which are sovereign, do not have that same option.
“We thought this was a ship kind of passing us by,” George Heavy Runner, Blackfeet Insurance Services health and wellness coordinator, told the Missoulian newspaper. “But it’s not just a ship passing through the night. We have been identified in this legislation, just not where we thought we would be.”
Attempts earlier this year by tribes to exempt themselves from the ACA failed in federal court. Regardless, according to Sen. Joh Tester, D-Montana, exempting tribes from the employer mandate still leaves the vexing problems with Indian health care. American Indians are, by treaty, eligible for health care via the Indian Health Service (IHS) on reservations. The agency, however, has come under fire over the years for what many tribal members say is inadequate service, and for not covering specialist services outside the IHS program.