"The Centers for Medicare and Medicaid Services, in implementing provisions of the Affordable Care Act, has added another level of complexity in the "who's an Indian" debate. In its recently published regulations, the agency defines Indians in the narrowest possible manner -- members of federally-recognized tribes.

The definition runs counter to long-standing landmark legislation established by the the Indian Health Care Improvement Act (1976), the Indian Self Determination and Education Assistance Act (1978), and even the existing Federal Tax Code. These Acts define Indians as members or descendants of recognized tribal members -- a definition used by the Indian Health Service to determine eligibility for health services.

If the narrow definition prevails, thousands of Alaska Native village members, California Indians and other legitimate Native descendants will become ineligible for special protections under the Affordable Care Act. The federal government and states that are planning to operate Health Insurance Exchanges may face a difficult challenge in trying to develop a single streamlined application for health insurance plans offered through Exchanges, Medicaid and Child Health Insurance Programs. Each program has different definitions of Indian that apply to the special provisions in the federal law."

Get the Story:
Dave Baldridge: Who's an Indian? The Feds Aren't So Sure (The Huffington Post 8/20)

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