Tribes Want Exemption from Expense of Health Care - Diverse Health

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Tribes Want Exemption from Expense of Health Care


by Ben Neary, Associated Press

Sen. Steve Daines

Sen. Steve Daines

CHEYENNE, Wyo.  — Representatives of several Indian tribes say they support legislation introduced by congressional Republicans that would exempt tribes nationwide from being classified as large employers under the federal Affordable Care Act — a designation that requires tribes to pay higher insurance costs or face federal penalties.
Supporters say requiring tribes to provide group insurance for tribal employees serves to shift the costs of implementing the Affordable Care Act from the federal government to the tribes. People who register for individual coverage under the act may qualify for federal tax credits, but that option’s not available to those who work for designated large employers.

Although Republicans have been struggling unsuccessfully to overturn the entire Affordable Care Act for years, the current effort to address the tribal large-employer requirement is remarkable so far for garnering significant Indian support.

In Montana alone, sponsors say they have the support of Crow, Blackfeet and Fort Peck Reservation’s Assiniboine and Sioux tribes. Those supporters say that federal penalties for failure to comply would reduce money available for essential tribal services.

The requirement for tribes that employ more than 50 employees to offer group insurance took effect Jan. 1. Individual Indians aren’t subject to tax penalties, as many other citizens are, if they fail to get individual coverage.

The Rosebud Sioux Tribe in Rosebud, South Dakota, also issued a statement this week in support of the bill, saying they, too, can’t afford to comply with the federal law.

“It is a United States treaty obligation to provide health care for members of the Rosebud Sioux Tribe,” Tribal President William Kindle and Treasurer Byron Wright stated.

Bill sponsor Sen. Steve Daines, R-Montana, issued a statement this week saying such unreasonable fines have the potential to kill reservation jobs and further cripple tribes’ economies.

“It is critically important that our tribes and tribal employees aren’t penalized due to a hastily written law,” he said.

Co-sponsors in the Senate include Sen. Mike Crapo, R-Idaho, and Sen. John Thune, R-South Dakota. Rep. Ryan Zinke, R-Montana, is sponsoring the bill in the House, where it’s co-sponsored by Rep. Kristi Noem, R-South Dakota.
U.S. District Judge Scott Skavdahl of Casper this month rejected a challenge from the Northern Arapaho Tribe in Wyoming to the large-employer insurance requirement. The judge found that determining the tribe qualifies as a large employer under the federal law doesn’t abrogate any rights guaranteed to it by treaty.

“If Congress wished to exempt Indian tribes from this mandate that otherwise might be reasonably construed as applying to them, it needed to do so explicitly,” Skavdahl wrote.

The Northern Arapaho Tribe employs roughly 1,000 workers at its casino and other government operations and previously had paid to help them cover individual insurance coverage under the Affordable Care Act. Dean Goggles, chairman of the Northern Arapaho Business Council, said Friday the pending bill offers a good way to cure the problem the tribe identified in its lawsuit.

The National Indian Health Board, a Washington, D.C.-based nonprofit, represents tribal governments on health care issues and supports the legislation to exempt tribes from the large-employer mandate.

Caitrin McCarron Shuy, director of congressional relations for the Indian Health Board, said Friday that federal law as it stands now presents Indians with a contradiction.

“I think this is a really critical issue for the tribal community to have to provide health insurance for employees,” Shuy said. “Under the law, of course as a large employer, tribes are required to provide health insurance. But most of their employees are also their tribal members, are native people who are exempt from the individual mandate. Really the two provisions of this law work at cross purposes from achieving what it was intended.”


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