1. Affordable Care Act Survey:
Impact on Tribes and Tribal Health Organizations
April 24, 2019
Presented by Doneg McDonough, CEO, Health System Analytics
Technical Advisor, TSGAC
Tribal Self-Governance Advisory Committee / TribalSelfGov.org

2. Survey jointly conducted by:
Impact on Tribes and Tribal health organizations
from Affordable Care Act (ACA) and reauthorized Indian Health Care Improvement Act (IHCIA):
Survey jointly conducted by:
Tribal Self-Governance Advisory Committee (TSGAC)
National Indian Health Board (NIHB)
National Congress of American Indians (NCAI)

3. Survey of Tribes and Tribal Health Organizations (THOs) on Impact of ACA
In late 2018, a survey was jointly conducted by TSGAC, NIHB, and NCAI
The eight question survey focused on impact of ACA on Tribes and THOs
68 Tribes and THOs responded to the survey
- 14 (21%) of the respondents were Title I contracting Tribes
- 54 (79%) of the respondents were Title V compacting Tribes
Survey results contain valuable information but are not necessarily representative of Tribes and THOs overall given over-representation of Title V compacting Tribes

4. Impact on Health Insurance Coverage

5. Participation in Tribal Sponsorship

6. Avenues for Expanding Health Insurance Coverage

7. Impact on Third-Party Revenues

8. Savings to Purchased/Referred Care (PRC) Program

9. Impact of Increased Third-Party Revenues

10. Impact of Employer Mandate

11. IRS Notices on Employer Shared Responsibility Payments