1. Health and Health Care for American Indians and Alaska Natives (AIANs) in the United States
April 2017

2. AIANs account for 2% of the United States population.
As of 2015, over 5 million individuals self-identify as AIAN alone or in combination with another race.
Under treaties and laws, the U.S. has a unique responsibility to provide certain rights, protections, and services to AIANs, including health care.
SOURCE: Kaiser Family Foundation analysis of the 2015 American Community Survey.

3. AIANs live across the United States, but over 60% reside in 11 states
AIANs live across the United States, but over 60% reside in 11 states. The majority of AIANs live outside of tribal areas.
Total = 5.4 Million
Note: AIAN includes people of mixed race and of Hispanic origin. Data include non-institutional, civilian individuals.
Source: Kaiser Family Foundation analysis of the 2015 American Community Survey.

4. Nonelderly AIANs are younger, more likely to be poor, and less likely to have a full-time worker in the family compared to Whites.
*Indicates statistically significant difference from the White population at the p<0.05 level.
NOTE: Whites and AIANs are non-Hispanic. Includes nonelderly individuals 0-64 years of age.
SOURCE: Kaiser Family Foundation analysis of March 2016 Current Population Survey, Annual Social and Economic Supplement

5. AIANs fare worse than Whites across many health measures.
Among Nonelderly Adults Ages 18-64
*Indicates statistically significant difference from White population at the p<0.05 level.
NOTE: Whites and AIANs are non-Hispanic.
SOURCE: Kaiser Family Foundation analysis of CDC, National Health Interview Survey, 2015, Kaiser Family Foundation analysis of CDC, Behavioral Risk Factor Surveillance System, 2015 and Results from the 2015 National Survey on Drug Use and Health: Detailed Tables,

6. Although the Indian Health Service (IHS) provides services to AIANs, health coverage is important for AIANs.
IHS is the primary vehicle through which the federal government provides health services to AIANs.
IHS has historically been underfunded to meet the health care needs of AIANs.
Enrolling AIANs in health coverage, including Medicaid or Marketplace coverage, expands their access to services and increases revenues to IHS and Tribal facilities.
SOURCE: Kaiser Commission on Medicaid and the Uninsured, Medicaid and American Indians and Alaska Natives, (Washington, DC: Kaiser Family Foundation, March 2016),

7. Medicaid and CHIP help fill gaps in private coverage for AIANs, particularly AIAN children, but they remain more likely to be uninsured than Whites.
Nonelderly Adults
Children
* Indicates statistically significant difference from the White population at the p<0.05 level.
Source: Kaiser Family Foundation analysis of March Current Population Survey, Annual Social and Economic Supplement.

8. More than one in ten uninsured AIANs would gain eligibility for coverage if all states expanded Medicaid.
Eligibility for ACA coverage among nonelderly uninsured AIANs as of 2016
Total: 0.5 M
Notes: Includes nonelderly individuals 0-64 years of age. AIANs are non-Hispanic. Tax Credit Eligible share in expansion states includes adults in MN and NY who are eligible for coverage through the Basic Health Plan. Medicaid/Other Public also includes CHIP and some state-funded programs for immigrants otherwise ineligible for Medicaid.
SOURCE: Kaiser Family Foundation analysis based on 2016 Medicaid eligibility levels and 2016 Current Population Survey.