ObamaCare exemptions and Native Americans

(note to mods: please find the correct forum. I tagged this to an ObamaCare thread
but the forum may not be appropriate.)
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As a Native American I am concerned how ObamaCare will affect my health care
services which are provided free-of-cost at the moment by our tribal hospital.

Also, and more to the point, will I be exempted from the requirement to pay for
insurance?

I have searched the text of the health care bill and there are 1900 references to
the word "Indian" in the bill. (I find it strange that Native Americans are still referred
to as "Indians" in this PC world).

First of all, tribes are not created equal, with each offering varying degrees of health
care and (I assume) receiving varying degrees of financial assistance from the federal
government--which could, and probably should, affect the degree to which I may
personally be affected

Also, (and probably what this thread will morph into...) It seems from my cursory
glance at the bill that people with certain religious beliefs will be exempted
from participation in ObamaCare. Most notably, those of the Muslim faith,
Scientologists, and the Amish.

I have added as an additional post, some of the text of the health care bill
that seems relevant to my question (with editing for brevity). I find most of
it incomprehensible, and this is just the tip of the iceberg

(9) SPECIAL RULES WITH RESPECT TO INDIAN
ENROLLEES AND INDIAN HEALTH CARE PROVIDERS.—

(A) CHOICE OF PROVIDERS.—The entity shall—(i) demonstrate
to the satisfaction of the Commissioner that it has contracted
with a sufficient number of Indian health care providers to ensure
timely access to covered services furnished by such providers to
individual Indians through the entity’s Exchange-participating health
benefits plan; and (ii) agree to pay Indian health care providers,
whether such providers are participating or nonparticipating providers
with respect to the entity, for covered services provided to those
enrollees who are eligible to receive services from such providers
at a rate that is not less than the level and amount of payment
which the entity would make for the services of a participating
provider which is not an Indian health care provider.

(B) SPECIAL RULE RELATING TO INDIAN
HEALTH CARE PROVIDERS.—Provision of services by an Indian
health care provider exclusively to Indians and their dependents
shall not constitute discrimination under this Act.
(10) PROGRAM INTEGRITY STANDARDS.—The entity shall
establish and operate a program to protect and promote the
integrity of Exchange-participating health benefits plans it
offers, in accordance with standards and functions established
by the Commissioner.



SPECIAL RULE RELATED TO COST-SHARING
AND INDIAN HEALTH CARE PROVIDERS.—The contract under
this section with a QHBP offering entity for a health benefits
plan shall provide that if an individual who is an Indian is enrolled
in such a plan and such individual receives a covered item or service
from an Indian health care provider (regardless of whether such
provider is in the plan’s provider network), the cost-sharing for
such item or service shall be equal to the amount of cost-sharing
that would be imposed if such item or service—
(A) had been furnished by another provider in the plan’s provider
network; or
(B) in the case that the plan has no such network, was furnished
by a non-Indian provider.

(6) NATIONAL PLAN.—Nothing in this section shall be construed
as preventing the Commissioner from entering into a contract under
this subsection with a QHBP offering entity for the offering of a
health benefits plan with the same benefits in every State so long
as such entity is licensed to offer such plan in each State and the
benefits meet the applicable requirements in each such State.



SEC. 545. EXCLUSION FROM GROSS INCOME FOR MEDICAL
CARE PROVIDED FOR INDIANS.
(a) IN GENERAL.—Part III of subchapter B of chapter 1 of the
Internal Revenue Code of 1986 (relating to items specifically
excluded from gross income) is amended by inserting after section
139C the following new section:
‘‘SEC. 139D. MEDICAL CARE PROVIDED FOR INDIANS.
‘‘(a) IN GENERAL.—Gross income does not include—

(1) health services or benefits provided or purchased by the Indian
Health Service, either directly or indirectly, through a grant to or
a contract or compact with an Indian tribe or tribal organization or
through programs of third parties funded by the Indian Health Service,
(2) medical care provided by an Indian tribe or tribal organization to
a member of an Indian tribe (including for this purpose, to the
member’s spouse or dependents) through any one of the following:
provided or purchased medical care services; accident or health
insurance (or an arrangement having the effect of accident or
health insurance); or amounts paid, directly or indirectly, to reimburse
the member for expenses incurred for medical care,
(3) the value of accident or health plan coverage provided by an Indian
tribe or tribal organization for medical care to a member of an Indian
tribe (including for this purpose, coverage that extends to such
member’s spouse or dependents) under an accident or health plan
(or through an arrangement having the effect of accident or health
insurance), and
(4) any other medical care provided by an Indian tribe that supplements,
replaces, or substitutes for the programs and services provided by the
Federal Government to Indian tribes or Indians.
(b) DEFINITIONS.—For purposes of this section—
(1) IN GENERAL.—The terms ‘accident or health insurance’ and ‘accident
or health plan’ have the same meaning as when used in sections 104 and
106.
(2) MEDICAL CARE.—The term ‘medical care’ has the meaning given
such term in section 213.
(3) DEPENDENT.—The term ‘dependent’ has the meaning given such term
in section 152, determined without regard to subsections (b)(1),
(b)(2),and (d)(1)(B).
(4) INDIAN TRIBE.—The term ‘Indian tribe’ means any Indian tribe,
band, nation, pueblo, or other organized group or community, including
any Alaska Native village, or regional or village corporation, as defined
in, or established pursuant to, the Alaska Native Claims Settlement Act
(43 U.S.C.20 1601 et seq.), which is recognized as eligible for the
special programs and services provided by the United States to Indians
because of their status as Indians. (5) TRIBAL ORGANIZATION.—The
term ‘tribal organization’ has the meaning given such term in section 4(l)
of the Indian Self-Determination and Education Assistance Act
(25 U.S.C. 450 (l)).’’
(b) CLERICAL AMENDMENT.—The table of sections for such part III
is amended by inserting after the item relating to section 139C the
following new item:


‘‘Sec. 139D. Medical care provided for Indians.’’
(c) EFFECTIVE DATE.—The amendments made by this section shall
apply to health benefits and coverage provided after the date of
enactment of this Act.
(d) NO INFERENCE.—Nothing in the amendments made by this section
shall be construed to create an inference with respect to the exclusion
from gross income of—
(1) benefits provided by Indian tribes that are not within the scope
of this section, and
(2) health benefits or coverage provided by Indian tribes prior to the
effective date of this section.

Kinda scary. What I wonder, could our IHS (Akwesasne) facility be classified as an HMO? Probably not. I've been wondering what the government will do.

reply to post by rival


You must be “Native American”. I however am part “Indian”, and proud of it. Get over your issue with semantics, it will be beneficial to your cause…Brother!

I noticed that all the wording you posted made a deliberate case of not noting/classifying these 'Indian groups' as 'Nations'

in the law, your Tribes can lose the status of 'Nation' if there is no contest to the wording of the HCR law,
by default the US government cuts your Tribes off from the status of 'Nation' and reduces you all to 'Indian' Individuals subject to the rules of this health care Law

? are youse all satisified with this situation?

Originally posted by meteoritics
reply to post by rival

 

You must be “Native American”. I however am part “Indian”, and proud of it. Get over your issue with semantics, it will be beneficial to your cause…Brother!

Naw, I'm not touchy in that regard. I just found it curious.

I just wish somebody could cull thru all the legalese in the bill and let us know how we'll be
affected. I tried, but ran out of steam when I realized how much work was involved with
answering a question as simple as this. The legal wording is prohibitive enough, if not
for the sheer volume of words that have to be read, understood and interpreted for
the layman. A daunting task. And no one seems to have the answer.

I honestly just want to know (when the time comes) will I be able to show my
employer or government rep my CDIB card and opt-out of ObamaCare, or
not.

Originally posted by St Udio
I noticed that all the wording you posted made a deliberate case of not noting/classifying these 'Indian groups' as 'Nations'

in the law, your Tribes can lose the status of 'Nation' if there is no contest to the wording of the HCR law,
by default the US government cuts your Tribes off from the status of 'Nation' and reduces you all to 'Indian' Individuals subject to the rules of this health care Law

? are youse all satisified with this situation?

NO....absolutely not. I'm not sure of the veracity of your statement, but it certainly scares me though.
I think I'll contact the tribal authority on this one...though I doubt I will get much information from
them.

I'm sure when the Feds start enforcing ObamaCare provisions I'l be made aware if they apply to me,
but until I doubt I'll know either way...

reply to post by rival


i honestly dont know what to make of this i beleive that is very telling of the insidious nature of the care act aka obamacare.


it should be bam you know what you are getting the same thing as everyone else is getting but wait its like " say that agian."


yeah man tribal council sounds like the plan to do always seek to educate yourself so you will never get the shaft.

good luck man for that fact good luck to us all we are going to need it.

Wow. That is a lot of legalese to wade through.

Some points I take from it (this is my interpretation) are:

1. Providers of health care services to Indians/Native Americans which existed before the health care bill was enacted will be able to continue to provide these services. Your IHS also may contract with the government to provide these and any other services required by the health care bill that are not presently covered.

2. Your tribal health care will exempt you from having to buy additional health insurance.

3. It looks like if you are satisfied with your present level of care and your provider these will remain unchanged.

This is what I take from it. My 2 cents.

As far as I recollect from the HCR is that you're required to have health insurance...not pay for it. If you're covered now, you'll be covered when the requirement goes into effect.

It's like vets and those who get care through the VA, they won't have to pay anything additional because they have health coverage.

reply to post by rival


Hey Rival. My apologies for telling you to get over it. I’m just Dammed proud of my Indian heritage. Indian seems better than Native American. The Indians were here long before it was America. If I were a black man, I would prefer to be called a Black man, not an African American. Just so very tired of all the PC crap we have to worry about…

As far as our healthcare goes you have some legitimate concerns, and are more informed than I am.

I wish someone would address the root cause of our healthcare problem. In my opinion it shouldn’t cost $1500 to be treated for the flu. I spent that last winter out of pocket for 4 chest x rays and a prescription. I knew I had the flu and pneumonia before I went in, just needed confirmation, and a prescription. H1N1 BTW…

Why do our universities get away with charging what they do for an education? Why are people forced to take classes that have nothing to do with their future profession? I couldn’t care less if my doctor knows advanced mathematics, Astronomy, or anything else not related to diagnosing, and treating me. It shouldn’t take nearly as long as it does to become a “Doctor”

And It shouldn’t cost what it costs, to acquire this information.

Real estate prices, even though down currently, have contributed to high healthcare costs. Even now, a descent building lease is more than it should be.

Insurance!! Legalized extortion… I don’t want to get too worked up right now so I will stop. I’m not conveying my thoughts properly.

My point is that there are many areas that could be addressed, as in reducing the cost of healthcare, not just trying to figure out how to pay the ridicules fees.

Example: My grandmother needed here hip put back in the socked. $30,000 plus! They called it surgery, but never cut her.

It happened again and a different hospital charged her $2500….WTF!

wow, what a very selfish thread you've posted here.

"How can just me get out of this mess??" - This would of summed up your question. Then you expect others who are left out to dry to do the research for you....

Way to go! inspiring the masses to unite against an overall tyrannical and oppressive legislation.

So, by your analysis, we should add some more unConstitutionality to Ocare by making special exemptions for certain ethnic groups or nationalities????

Im sorry if this seems a bit hostile but I'm so sick of racial and political divisive rhetoric. When is the ME generation going to die out and stop dividing the American people? We should ALL unite together against Ocare and not try to find loopholes for just ourselves to "get out of it"

Indian, African, Asian, Caucasian, Whatever, IF you are a citizen of the US you are nothing but an American. Unite with your brothers if you enjoy it here.

rival


NO....absolutely not. I'm not sure of the veracity of your statement, but it certainly scares me though.
I think I'll contact the tribal authority on this one...though I doubt I will get much information from
them.

I'm sure when the Feds start enforcing ObamaCare provisions I'l be made aware if they apply to me,
but until I doubt I'll know either way...

So.... did anything get explained or made clearer to you ?


i myself on 1 Nov went in to the scheduled Primary Care VA Doctor on 1 Nov...

the replacement primary care person was a Physician Assistant... the year ago New Doctor quit that VA position...


the 'Mature' grey haired woman that was my new primary care person went strictly by the book and done her diagnosis' strictly on the blood count numbers/statistics

my 20 allotted minutes were done before i could ask for a pill other than Ibuprofen for feet & toes that ached from overstretching or flexing



i received a semi-personal form letter the next day citing my visit under the ACA healthcare program (formerly the VA)


the prescriptions i usually get a week-to-ten days after the visit were there by UPS only 4 days later , instead of USPS



i seen a very studying eye sizing me up...because i'm over 65 no doubt.... i did hear a surprised comment from the PA..... " You Take very few medications..." " your diet and healthy living choices are good..."


I think i passed the first screening OK
so this baby-boomer won't be on the cull list at least not right away

reply to post by AzoriaCorp


Hey, I am against Obamacare 100%, but I was curious if what I'd heard was true - namely, that if you can claim Native heritage, you are pretty much exempt from Obamacare. It won't matter for me, but it might save my husband and son. Until Obamacare is defeated, I'll take any strategy I can find to help save my family.