1. T RIBAL P ERSPECTIVE ON THE A FFORDABLE C ARE A CT NPAIHB Quarterly Meeting June 25 th, 2014 Hosted at Quinault Nation

2. T RIBAL A SSISTER P ROGRAM Created by the Exchange with input from AIHC and the Tribal Get Covered Workgroup Trained and Certified to log into the Washington Healthplanfinder (HPF) Higher Level of Access into HPF System Allowed to manually verify Tribal enrollment

3. T RIBAL A SSISTER A RE A LREADY Culturally competent People community members already know and can trust Understand basics of Tribal Issues related to ACA Tribal enrollment Tribal exempt income Per capita payments

4. T RIBAL A SSISTER N EEDED Better understanding of the ACA Training on the special provisions for AI/AN Training in the HPF to Complete and application; Ensure application is filled out so the special protections for AI/AN are processed correctly;

5. T RIBAL A SSISTER T OOLS AND R ESOURCES C REATED : Tribal Assister Certification Checklist Indian Health Care Reform Manual for Washington State http://www.aihc-wa.com/aihc-health-policy- issues/indian-health-care-reform-manual-for-wa-state/ Tracking System for Help Tickets for the HPF Tribal Get Covered Workgroup

6. T RIBAL A SSISTER I SSUES T O B E R ESOLVE : Sponsorship- better process for Tribes to pay premiums for their members; Application issues for completing and application for a “mixed” family; State staff understanding the status of a Tribal Assister

7. T RIBAL A SSISTER S TATS : Meet weekly since October 1, 2014; Use Webinar format to allow participation in meetings without travel and related costs; average about 40 participants per week. 26 out of 29 Tribes have at least one certified Tribal Assister - two more Tribes have at least one in training. Both Urban Indian Health Programs have at least one Tribal Assister Over 100 Tribal Assister certified in Washington State.