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Research Letter | Health Care Reform

Health Reform and Coverage Changes Among Native Americans

Molly Frean, BA1; Shelbie Shelder1; Meredith B. Rosenthal, PhD1; Thomas D. Sequist, MD, MPH2,3; Benjamin D. Sommers, MD, PhD1,4
[+] 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
JAMA Intern Med. 2016;176(6):858-860. doi:10.1001/jamainternmed.2016.1695.
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This study evaluates changes in insurance and Indian Health Service coverage among Native Americans following the Affordable Care Act’s implementation.

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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