CHEYENNE, Wyo. (CN) - Poverty stricken Native Americans in Wyoming are scrambling to protect their exemptions under Obamacare before the "large employer" mandate takes effect Jan. 1, 2015.
The Northern Arapaho Tribe sued the U.S. Department of Health & Human Services and the U.S. Department of the Treasury Secretary on Monday in a federal class action.
The 2010 Patient Protection and Affordable Care Act aka Obamacare provides Native Americans with an exemption from the individual and large employer mandates.
But the Arapaho say the implementing regulations have "perhaps inadvertently, created unlawful barriers that block Native Americans from accessing the Premium Tax Credits and the Cost Sharing Exemption that Congress provided."
The Arapaho claims the regulations "will deprive Native Americans of critical health care assistance by re-writing provisions of the ACA in violation of federal law."
Roughly 24,000 Arapaho live on the 3,473-square-mile Wind River Indian Reservation in west central Wyoming. Their median income is about $16,000 per year - just 31 percent of the $51,900 median income of the country as a whole.
Arapaho enterprises employ about 600 people, at casinos, a grocery store, gas station and laundry service.
Providing them with health insurance is difficult due to lack of bargaining power with health care providers and skyrocketing costs, the tribe says.
The Affordable Care Act could have provided impoverished Native Americans access to "high quality," low-cost insurance, the tribe says, but the implementing regulations blocked it.
"Contrary to the intent of Congress, when the cluster IRS regulation and rules implementing the ACA Large Employer mandate takes effect on Jan. 1, 2015, tribal employees will be deprived of the coverage currently in place under policies provided on the exchange," the complaint states. "Under the new IRS rules and regulations ... tribal employees will be offered two inferior insurance options: 1) an exchange plan without the ... premium tax credits and the cost sharing exemption; or 2) an employer plan that is more expensive and does not provide a cost sharing benefit."
Either way, costs will increase and coverage will decrease, which is violates the purpose of the lie, the Arapaho say.
"The IRS apparently considers the tribe and its enterprises to fall within its definition of a large employer," the complaint states. "If the tribe is subjected to the large employer mandate, defendants will effectively block tribal member employees between 100 percent and 400 percent of poverty from premium tax credits that subsidize insurance coverage available on the exchanges and nullify the statute by regulation," according to the complaint.
Tribal employees below 300 percent of the poverty level - i.e., those at the tribal median income level - will be blocked from the cost-sharing exemption, the Arapaho say.
"Congress did not intend to create special benefits in the ACA for working-class Native Americans, only to have defendants promulgate regulations that prevent working-class Native Americans who work for tribes from obtaining those benefits," the complaint states.
The Arapaho want the court to declare the large employer mandate unlawful as applied to them, prohibit the government from fining the tribe for noncompliance and issue an injunction that allows them access health insurance as it currently exists.
The tribe is represented by Andrew Baldwin with Baldwin Crocker & Rudd, of Lander, Wyo.
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