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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Frean et al. (2016) studied this question.
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