Los Angeles American Indian and Alaska Native Project1 Technical Memo 4: AIAN Health Insurance Coverage

This technical memo examines health insurance coverage of AIANs in Los Angeles. Previous studies have found that AIANs are significantly less likely to have access, particularly to private insurance (Kaiser Commission on Medicaid and the Uninsured, 2000; American Indians and Alaska Natives: Health Coverage and Access to Care, 2004; Urban Indian Health Institute, 2012). The gap is particularly noticeable when compared to non-Hispanic whites. An analysis of the 2009, 2010, and 2011 American Community Survey Public Use Micro Sample (ACS PUMS) data documents this disparity in the region, although there are variations between AIANs alone (those who self-reported being only AIAN) and multiracial AIANs (those who self-reported being AIAN and at least one other racial category), with the former faring worse. Demographic, socioeconomic, and health factors contribute to the gap in access to health insurance, but being AIAN is correlated with lower coverage beyond these factors. Although many AIANs are eligible for Indian Health Services (I.H.S.), participation is extremely low, a pattern shared by other urban AIANs. AIANs face a number of challenges and opportunities with the Patient Protection and Affordable Care Act (a.k.a. Obamacare) and the responses to the “fiscal cliff.”