---
kind: "section"
citation: "25 U.S.C. § 1623"
title: "25"
title_heading: "Indians"
number: "1623"
heading: "Special rules relating to Indians"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/25/1623"
units:
  - "Chapter 18 — Indian Health Care"
  - "Subchapter II — Health Services"
---

# §1623. Special rules relating to Indians

- (a) **No Cost-sharing for Indians with income at or below 300 percent of poverty enrolled in coverage through a State Exchange—** For provisions prohibiting cost sharing for [Indians](/usc/25/1603.md?p=13) enrolled in any qualified health plan in the individual market through an Exchange, see [section 18071(d) of title 42](/usc/42/18071.md?p=d).
- (b) **Payer of last resort—** Health programs operated by the [Indian](/usc/25/1603.md?p=13) Health [Service](/usc/25/1603.md?p=18), [Indian tribes](/usc/25/1603.md?p=14), [tribal organizations](/usc/25/1603.md?p=26), and [Urban Indian organizations](/usc/25/1603.md?p=29) (as those terms are defined in [section 1603 of this title](/usc/25/1603.md)) shall be the payer of last resort for [services](/usc/25/1603.md?p=18) provided by such [Service](/usc/25/1603.md?p=18), tribes, or organizations to individuals eligible for [services](/usc/25/1603.md?p=18) through such programs, notwithstanding any Federal, State, or local law to the contrary.

## Source credit

(Pub. L. 111–148, title II, § 2901(a), (b), Mar. 23, 2010, 124 Stat. 333.)

## Notes

### Editorial Notes

### Codification

Section is comprised of subsecs. (a) and (b) of section 2901 of Pub. L. 111–148. Subsections (c) and (d) of section 2901 amended sections 1396a and 1320b–9, respectively, of Title 42, The Public Health and Welfare.

Section was enacted as part of the Patient Protection and Affordable Care Act, and not as part of the Indian Health Care Improvement Act which comprises this chapter.