II 

114TH CONGRESS 

1ST SESSION S. 2114 

To correct inconsistencies in the definitions relating to Native Americans 

in the Patient Protection and Affordable Care Act. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 1, 2015 

Ms. MURKOWSKI (for herself, Mr. SULLIVAN, and Mr. SCHATZ) introduced the 

following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To correct inconsistencies in the definitions relating to Native 

Americans in the Patient Protection and Affordable Care 

Act. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. TECHNICAL CORRECTIONS TO PPACA. 

4 (a) DEFINITION OF INDIAN.—Section 1304 of the 

5 Patient Protection and Affordable Care Act (42 U.S.C. 

6 18024) is amended by adding at the end the following: 

7 ‘‘(f) INDIAN.— 

8 ‘‘(1) IN GENERAL.—In this title, the term ‘In9 dian’ means any individual— 


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1 ‘‘(A) described in paragraph (13) or (28) 

2 of section 4 of the Indian Health Care Improve3 ment Act (25 U.S.C. 1603); 

4 ‘‘(B) who is eligible for health services pro5 vided by the Indian Health Service under sec6 tion 809 of the Indian Health Care Improve7 ment Act (25 U.S.C. 1679); 

8 ‘‘(C) who is of Indian descent and belongs 

9 to the Indian community served by the local fa10 cilities and program of the Indian Health Serv11 ice; or 

12 ‘‘(D) who is described in paragraph (2). 

13 ‘‘(2) INCLUDED INDIVIDUALS.—The following 

14 individuals shall be considered to be an ‘Indian’: 

15 ‘‘(A) A member of a Federally-recognized 

16 Indian tribe. 

17 ‘‘(B) A resident of an urban center who 

18 meets 1 or more of the following 4 criteria: 

19 ‘‘(i) Membership in a tribe, band, or 

20 other organized group of Indians, including 

21 those tribes, bands, or groups terminated 

22 since 1940 and those recognized now or in 

23 the future by the State in which they re24 side, or being a descendant, in the first or 

25 second degree, of any such member. 


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1 ‘‘(ii) Is an Eskimo or Aleut or other 

2 Alaska Native. 

3 ‘‘(iii) Is considered by the Secretary of 

4 the Interior to be an Indian for any pur5 pose. 

6 ‘‘(iv) Is determined to be an Indian 

7 under regulations promulgated by the Sec8 retary. 

9 ‘‘(C) An individual who is considered by 

10 the Secretary of the Interior to be an Indian for 

11 any purpose. 

12 ‘‘(D) An individual who is considered by 

13 the Secretary to be an Indian for purposes of 

14 eligibility for Indian health care services, includ15 ing as a California Indian, Eskimo, Aleut, or 

16 other Alaska Native.’’. 

17 (b) CONFORMING AMENDMENTS.— 

18 (1) AFFORDABLE CHOICES HEALTH BENEFIT

19 PLANS.—Section 1311(c)(6)(D) of the Patient Pro20 tection and Affordable Care Act (42 U.S.C. 

21 18031(c)(6)(D)) is amended by striking ‘‘section 4 

22 of the Indian Health Care Improvement Act’’ and 

23 inserting ‘‘section 1304(f)’’. 

24 (2) REDUCED COST-SHARING FOR INDIVIDUALS

25 ENROLLING IN QUALIFIED HEALTH PLANS.—Section 


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•S 2114 IS

1 1402(d) of the Patient Protection and Affordable 

2 Care Act (42 U.S.C. 18071(d)) is amended— 

3 (A) in paragraph (1), in the matter pre4 ceding subparagraph (A), by striking ‘‘section 

5 4(d) of the Indian Self-Determination and Edu6 cation Assistance Act (25 U.S.C. 450b(d))’’ and 

7 inserting ‘‘section 1304(f)’’; and 

8 (B) in paragraph (2), in the matter pre9 ceding subparagraph (A), by striking ‘‘(as so 

10 defined)’’ and inserting ‘‘(as defined in section 

11 1304(f))’’. 

12 (3) EXEMPTION FROM PENALTY FOR NOT

13 MAINTAINING MINIMUM ESSENTIAL COVERAGE.— 

14 Section 5000A(e) of the Internal Revenue Code of 

15 1986 is amended by striking paragraph (3) and in16 serting the following: 

17 ‘‘(3) INDIANS.—Any applicable individual who 

18 is an Indian (as defined in section 1304(f) of the 

19 Patient Protection and Affordable Care Act).’’. 

Æ 


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