Shareholder News

Important Affordable Care Act Exemption Paperwork for Alaskan Natives that will save people the Tax Penalty

Wednesday, January 22, 2014

Beginning January 1, 2014, every American must demonstrate health care coverage under the Affordable Care Act (ACA), but there are special exemptions that apply to Alaska Native and American Indian people. The landscape of health care insurance is changing quickly. Here is what Alaska Native and American Indian people around Alaska need to know.

In March 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act, into law. The law makes preventive care more accessible and affordable for many Americans. While some provisions of the law have already taken effect, many more provisions will be implemented in the coming years.

One of the biggest pieces of the ACA is the requirement that most Americans have health care coverage. If you don’t have health care coverage for you and your family, you could be assessed a tax penalty in 2014 of $95-$285, depending on your income levels. As the years go on, the penalty will increase.

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

• Enrollment in a federally recognized Tribe,
• Alaska Native Claims Settlement Act (ANCSA) shareholder status (village or regional) or
• Eligibility to receive services from an Indian Health Service (IHS) facility/Tribal health care provider

What if I have insurance?

• My employer provides insurance
• I am enrolled in Medicare
• I am enrolled in Medicaid
• I am enrolled in Denali KidCare
• I am enrolled in Veteran Benefits
If any of the conditions above apply to me, then I have satisfied the "Individual Mandate" and do not need to purchase additional health care coverage to avoid the tax penalty.


Q: How do I qualify for the Alaska Native and American Indian exemption?

A: To qualify for this exemption, Alaska Native and American Indian people will have to apply for the exemption through a paper application process. This paper application can be printed at

ANTHC has created a version of the paper application with helpful tips on how to fill it out. This version of the application can be read and printed at:

When you complete the application, you must send copies of supporting documents, such as:

Preferred documents:

• Tribal enrollment card/letter
• Proof of ANCSA Shareholder Status (Regional or Village)
These documents ensure you qualify for ACA special benefits for Alaska Natives and American Indians
Other accepted documents:
• Certificate of Indian Blood (CIB) card issued by the Bureau of Indian Affairs (BIA)
• IHS Eligibility Letter

*Please do not send originals of these documents as they will not be returned to you.*

Please remember to complete Step 2 of the application for all members of your family, including children. Also, be sure to send copies of the same supporting documents for every member of your family that needs the Indian Status Exemption to avoid a tax penalty.

Within 2-4 weeks of mailing the form, the Federal government will inform you if they need additional information. If you receive this exemption, you will be sent an Exemption Certificate Number that you will put on your federal income tax return. It is important to keep a copy of this Exemption Certificate Number in a safe place for future use. If you do not hear from the Federal Government within 4-6 weeks, contact the Health Insurance Marketplace Help Center at 1-800-318-2596.

ANTHC’s Health Reform group is traveling to Alaska’s regional hubs through March 2014, distributing paper applications and offering assistance to anyone who has questions or needs help filling out the forms.

For assistance with the Indian Exemption Status paperwork and to learn more information about the ACA in Alaska, visit your local Tribal clinic or contact the ANTHC Health Reform group at , (907) 729-7777 or (855) 882-6842.

Frequently asked questions about the ACA:

Q: What if I already have health care coverage?

A: If you have health care coverage through Medicaid, Medicare, Denali KidCare, Veteran’s Benefits or your employer provides health insurance, you have met the requirements of the Individual Mandate and do not need to purchase additional health care coverage to avoid the tax penalty. You do not need to complete the Indian Status Exemption paperwork if you have health care coverage. However, the Indian Exemption is a lifetime exemption.

Q: If I don’t buy insurance, will I still be able to get health care services at my IHS/Tribal health facility?

Yes, you will still be able to get care at your IHS/Tribal health facility. The health care services provided at IHS/Tribal health facilities are not changing. However, you will need to apply for an exemption.

Q: How do I enroll in a Tribe?

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

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 and resources on this topic, please visit the ANTHC website at: