The American Indian health system is difficult to navigate. American Indians have historically had a high rate of being in poverty, being uninsured, and poor access to care. Oklahomans overall also have a high uninsured rate and poor access to care. This thesis is descriptive study using literature regarding the American Indian health care system in Oklahoma post the Affordable Care Act (ACA). This thesis reviews the ACA and examines the unique American Indians aspects of the act. The ACA has had many positive impacts on American Indian insurance enrollment as well as access to care but there is much more work that needs to be done in Oklahoma in order to diminish American Indian health disparities.