American Indian Exceptionalism

Max Baucus' bill makes you pay a fine if you don't have health insurance—unless you're American Indian.

By Christopher Beam
Posted Friday, Sept. 18, 2009, at 11:20 AM ET

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The health care plan released by Senate Finance Committee Chairman Max Baucus on Wednesday includes a requirement that every nonsenior American either buy insurance or pay a fine. There are exceptions, however, for anyone below the poverty line, people who face extreme hardship, and American Indians. (Read the bill summary here.) Why are American Indians exempt?

Because they have their own health care system. The Indian Health Service, which operates under the Department of Health and Human Services and whose funding comes out of the federal government's annual budget, provides care to any person who is a member or descendant of one of the 560 federally recognized tribes. Because they're covered by IHS, Indians don't need to purchase private insurance. (Many do anyway—more on that later.)