The ACA includes provisions for American Indians and Native Alaskans that make purchasing insurance on the exchange an even better proposition than it is for everyone else. They can sign up at any time - there are no open enrollment deadlines. Tribal members with incomes below 300 percent of the federal poverty level ($34,470 for an individual) are exempt from paying deductibles and copays, so they can purchase the cheapest plans without worrying about out-of-pocket expenses. All tribal members, no matter what income level, are exempt from out-of-pocket payments if they receive services from Indian health facilities. And unlike employers, tribes can pay exchange premiums for their members without paying taxes. In addition, a separate law that has governed Native American health care for decades - the Indian Health Care Improvement Act - was amended when the ACA was signed. New provisions make it easier for Indian health facilities to accept payments from other insurers, including Medicaid, Medicare and private insurance. The new law also expands the types of services the facilities can offer and requires inclusion of behavioral health and substance abuse treatments.