Health disparities profoundly impact American Indians and Alaska Natives (AI/AN), who experience shorter life expectancies, higher disease burdens, and poorer overall health status than the general population. Toward its aim of developing a national strategy to improve health care delivery, outcomes, and population health, the Affordable Care Act (ACA) includes provisions addressing racial and ethnic disparities in health and health care. Specific provisions focus on the chronic disparities in health care quality and access facing AI/AN populations. The ACA has important implications for AI/ANs, including the expansion of Medicaid coverage to nearly 400,000 currently uninsured AI/AN individuals.

This brief, produced under the Robert Wood Johnson Foundation’s State Health Reform Assistance Network, explores opportunities presented by the ACA to improve health care access, coverage, quality, and outcomes for AI/AN populations. The brief outlines provisions that uniquely affect AI/ANs and provides strategies to help states and other stakeholders realize the potential of the ACA to improve the health and health care of AI/AN individuals. Areas addressed include: (1) coverage expansion; (2) state outreach to and engagement with federally recognized tribal groups; and (3) opportunities to fill gaps in the organization and financing of care.