Murkowski Presses Administration About Double Standard on Alaska Native Treatment in Health Care Law

Senator to HHS: You Fix the Law for Other Groups, Why Not Alaska Natives?

Senator Lisa Murkowski is reaching out to the Secretary of Health and Human Services to resolve the problem of how “Indian” is defined within the Affordable Care Act.  Many Alaska Natives are presently blocked from securing the protections and exemptions afforded to them under the law.  The narrow current definition is inconsistent with the existing one for Alaska Natives under several federal health programs, because many young Alaska Natives are not shareholders in ANCSA corporations that stopped enrolling new members in the 1970s.

After months of working to correct this mistake through other federal agencies, as well as cosponsoring legislation to achieve this goal in the 113th Congress, Murkowski took the case directly to the Cabinet member in a letter (attached) – noting the Obama Administration has made 30 different voluntary fixes or delays to the law when it suited their political interests.

During a hearing … [Indian Health Service Interim Director] Dr. Yvette Roubideaux was asked why a change that would address this problem could not be made administratively, as Congress had been led to think was possible by her predecessor, Kathleen Sibelius.  Dr. Roubideaux responded that the definitions were written into the statute and would require a legislative fix, but would like to work together and find a solution to this problem.  Given the number of changes the Administration has made to the ACA during the implementation process that are at odds with language in the statute, this answer is unsatisfactory.  The Galen Institute has catalogued 30 unilateral changes.

For example, the employer mandate has been delayed twice – first until 2015, then until 2016; a one-year grace period was implemented to give service providers more time to comply with the ACA’s annual cost-sharing limits; the Basic Health Program was delayed by one year; a two-year transition period was established for those customers who wished to keep insurance plans that did not comply with the law; and a multitude of special enrollment periods have been created.  Finally, the IRS allowed subsidies to go through federally-operated exchanges, rather than state-based ones, which is now the subject of the pending lawsuit King v. Burwell.

Since all of these directives appear contrary to statutory language, why can the Administration not make a small change that would allow more Alaska Natives the ability to qualify for an exemption?

Senator Murkowski plans to continue seeking a resolution on this issue for Alaska’s First People, and will push for answers.