• SIOUX FALLS, S.D. (AP) -- Insurance enrollment helpers are encouraging Native Americans to sign up for coverage under the nation's new health care law, saying it will help them better access X-rays, mammograms, prescription drugs and trips to specialists not covered under Indian Health Service.
• American Indians are exempt from the Affordable Care Act's requirement that people carry insurance, but the law opens up resources that for years have been limited through IHS, said Jerilyn Church, executive director of the South Dakota-based Great Plains Tribal Chairmen's Health Board.
• "There's a huge gap in access to services, so being enrolled in the marketplace is going to make a big difference in terms of accessibility to health care," Church said.
• The Indian Health Service, a branch of the U.S. Department of Health and Human Services, provides free health care to enrolled members of tribes, their descendants and some others as part of the government's treaty obligations to Indian tribes dating back nearly a century.
• Critics long have complained of insufficient financial support that has led to constant turnover among doctors and nurses, understaffed hospitals, sparse specialty care and long waits to see a doctor.
• The Great Plains Tribal Chairmen's Health Board received $264,000 in South Dakota and $186,000 in North Dakota to assist with Native American signups on the states' reservations and urban areas.
• The new law health care law will especially benefit people who seek treatment at urban Indian health clinics, which collectively are funded by just 1 percent of the IHS budget, said Ashley Tuomi, executive director of the American Indian Health and Family Services clinic in Detroit.
• "Our resources are extremely limited, even more so than the tribes," Tuomi said. "What we have within our walls is what we can offer for free."
• The clinic has seen a lot of patient interest in the health care marketplace, but "navigators" helping with signups have had to cancel many appointments because of continued issues with the federal healthcare.gov website, Tuomi said.
• The Ponca Tribe of Nebraska has received about $38,000 in federal grant funds to encourage signups for tribal members scattered in 12 counties in Nebraska, two

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