A repeal of the ACA would pose a significant threat to Alaska Native communities

After the first day of the Supreme Court hearing on the constitutionality of the Affordable Care Act, initial comments from some justices indicate that a repeal of the landmark law is unlikely. However, the mere fact that the law is being challenged at the Supreme Court is unnerving for the many Alaskans who rely on the protections included in it.

A key provision of the ACA is its expansion of Medicaid eligibility requirements. As of October 30, 2020, 26% of Alaskans receiving Medicaid benefits were doing so through Medicaid expansion, meaning that at least 61,847 Alaskans will lose their coverage if the ACA is repealed.


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Furthermore, Alaska’s large indigenous communities heavily rely on the law for access to health care, and if the ACA is overturned, Native Alaskans will be disproportionately affected. Many would lose their health care, and the COVID-19 pandemic — which has recently intensified in the state, with a record 601 daily cases reported on November 7– only makes this threat more concerning.

Despite making up only 14% of Alaska’s population, American Indigenous and Alaska Native populations represent 30% of COVID deaths in the state, according to data from the COVID Tracking Project. According to the Centers for Disease Control and Prevention, American Indians and Alaska Natives are 5.3 times more likely than others to be hospitalized from COVID.

Many Alaska Natives rely on the Medicaid expansion provisions established by the ACA, along with millions of Native Americans across the country.

“An estimated 290,000 Native Americans and Alaska Natives receive health coverage through the Affordable Care Act’s Medicaid expansion. All of that is at risk if the Supreme Court overturns the Affordable Care Act,” tweeted New Mexico Senator Martin Heinrich on Tuesday.

The Affordable Care Act also reauthorized the Indian Health Care Improvement Act, an important law pertaining to Native Country’s health care. This legislation gives additional funding to the Indian Health Service which, along with tribal and urban Indian health care services, provide health care to Alaska Natives and American Indians who need it.

“The Indian Health Care Improvement Act is foundational to the Indian health system and how it operates. Similarly, the Affordable Care Act has been integral to improving access to care for tribal citizens, bringing significant revenue sources into the chronically underfunded Indian health system and stabilizing tribal and IHS health systems,” said Walker River Paiute Tribe Chairwoman Amber Torres on October 18th at the National Tribal Health Conference.