On March 23, 2010 President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law in an effort to provide affordable health insurance to all Americans. The landscape of health insurance is now changing rapidly. Beginning January 1, 2014, every American must demonstrate health care coverage under the Affordable Care Act; however, Native Americans and Alaska Natives have special provision including cost savings programs, special monthly enrollment periods, and Native American tax exemptions. All Americans who do not have minimum essential coverage will pay a tax penalty, called the Individual Shared Responsibility Payment (also known as the individual mandate or tax penalty), billed to their tax return to help pay for healthcare reform beginning April 15, 2015 for the 2014 tax filing year. It is optional for Absentee Shawnee tribal members and their descendants to purchase coverage on the Health Insurance Marketplace because Native Americans and Alaska Natives are exempt from the Individual Shared Responsibility Payment. Americans are also exempt from the Individual Shared Responsibility Payment if you currently have and maintain minimum essential coverage, such as SoonerCare/Medicaid-CHIP, Medicare, Tricare, employer insurance, or commercial insurance (whether native or non-native). No action is required for individuals with minimum essential coverage, unless you have a lapse in coverage for 3 months or more (then you will need to file your Native American exemption application). If you do not have minimal essential coverage, then it's "My Health, My Choice!" You will need to take action and make one of three choices before the 2014 enrollment period ends for Native Americans on December 31, 2014. To learn more about your "My Health, My Choice" options, try our "My Health, My Choice" Decision Tool.