Health law could require some American Indians to buy insurance or pay penalties

May 15 2013

The Associated Press reports that the overhaul's definition of "American Indian" only includes those tribes that are recognized by the federal government, though more than 100 tribes are recognized by state governments but not that U.S. Bureau of Indian Affairs. Other outlets report on insurance rates under the ACA, doctor-owned hospitals and the much lamented "doc fix" in Congress.

The Associated Press: Health Reforms Penalize Some American Indians
They will have to buy their own health insurance policies or pay a $695 fine from the Internal Revenue Service unless they can prove that they are "Indian enough" to claim one of the few exemptions allowed under the Affordable Care Act's mandate that all Americans carry insurance. "I'm no less Indian than I was yesterday, and just because the definition of who is Indian got changed in the law doesn't mean that it's fair for people to be penalized," said DeRouen, a former tribal administrator for the Dry Creek Rancheria Band of Pomo Indians who lost her membership amid a leadership dispute in 2009. ... The Affordable Care Act takes a narrow view of who is considered an American Indian and can avoid the tax penalty. It limits the definition to those who can document their membership in one of the approximately 560 tribes recognized by the U.S. Bureau of Indian Affairs (Burke, 5/13).

CNN Money: Who Will Pay More Under Obamacare? Young Men
The Obama administration says the Affordable Care Act will provide cheaper health insurance for millions of Americans. But some people, particularly young men who aren't insured through their employers, could see their premiums go up once coverage in the state-based insurance exchanges begins in January. Many groups have come out with reports forecasting what will happen to premiums, on average, next year. But just what folks will pay for insurance on the individual market depends on a variety of factors. They include the enrollee's income, age, gender, current coverage level and state of residence (Luhby, 5/14).

The Wall Street Journal: Doc-Owned Hospitals Prep To Fight
The Affordable Care Act aimed to end a boom in doctor-owned hospitals, a highly profitable niche known for its luxury facilities. Instead, many of the hospitals are wiggling around the federal health-care law's growth caps and even thriving. The law, passed in 2010, blocked building any new physician-owned hospitals and prevented existing ones from adding beds or operating rooms in order to qualify for Medicare payments. The drafters wanted to clamp down on a sector that some policy experts contend is prone to perform unnecessary procedures at high prices, driving up overall health spending (Mundy, 5/13).

In other news related to physicians -

Modern Healthcare: Doc Pay Reform Remains A 'Top Priority'
Physician advocates see signs of progress in the Senate Finance Committee's hearing Tuesday-;the panel's first in six years on replacing Medicare's physician payment system. Sen. Max Baucus (D-Mont.) last convened a hearing to replace Medicare's sustainable growth-rate formula, which determines physician payments, on March 1, 2007. That hearing was followed by the contentious battle over the passage of the Patient Protection and Affordable Care Act, which was notably silent on Medicare's physician payment system (Daly, 5/13).