- The Washington Times - Thursday, September 5, 2013

Government investigators say more than half of Americans Indians and Alaskan Natives — “hundreds of thousands” of them — will be eligible for benefits tied to Obamacare, but federal officials are not doing enough to link them with coverage options that kick in next year.

The Government Accountability Office said the Indian Health Sevice and the federal Medicaid office need to reach out to the affected populations because in 2014 they could be newly eligible for Medicaid — at least in states that choose to expand the program — or subsidies that will begin to offset the cost of health plans purchased through state-based exchanges.

The Medicaid category is a moving target, since the Supreme Court said states can opt not to expand the federal-state entitlement for the poor without losing existing federal funds for the program.

“While it is still unclear which states will opt to expand Medicaid, their decisions may affect a large proportion of American Indians and Alaska Natives, as GAO estimates that potential new enrollment could include about a quarter of this population,” the study said.

So far, about half of the states are moving to expand the program under President Obama’s reforms.

If all the states expanded Medicaid, GAO said that new Medicaid enrollees among the American Indians and Alaskan Native population could exceed more than 650,000 out of 2.4 million people who identify as part of the natives groups alone, or almost 1.2 million out of the 4.8 million who identify with one of the groups and another race.

The study said in Oklahoma, “tens of thousands” of Indians could be affected by the state’s decision not to expand Medicaid to those making up to 133 percent of the federal poverty level.

More than a third of American Indians and Alaskan Natives may be eligible for premium tax credits to defray the cost of insurance on state exchanges, which open Oct. 1, the study said.

Specifically, it said about 832,000 who identify with one of the native groups alone and 1.7 million who identify with one of the group and another race would be eligible for the credits.

Investigators said while the federal government made some strides to inform the affected population of their options, many facilities and tribes reported receiving little or no information about potential benefits.

Additionally, some federal officials reported they had delayed outreach while waiting for the Supreme Court’s June 2012 ruling on Obamacare and state-based decisions on whether to expand Medicaid.

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