ICHS Press Release: Over 400,000 Have Health Care Insurance Within Reach

Over 400,000 uninsured Hoosiers have access to health insurance coverage within their reach; however, they are sitting on the sidelines waiting for the State of Indiana to act. Indiana has a historic opportunity to expand Medicaid coverage for individuals who make under 138 percent of the Federal Poverty Level under the Affordable Care Act (ACA). However, discussions have stalled at the Statehouse, and the Governor’s office is pursuing expansion of the Healthy Indiana Plan (HIP) as a means to provide coverage to this donut hole of Hoosiers.

While the HIP program has been successful in providing coverage to thousands of Hoosiers, there are modifications that need to be made to the program to ensure it is the best vehicle for expanding coveragefor eligible Hoosiers. These modifications are informed by the regulations outlined in the ACA and based on reports from individuals and providers who currently work with the HIP program. Below are four of the main concerns with the proposed HIP program waiver:

•There are concerns with the existing capped enrollment in HIP and the need for caps to be removed to ensure all eligible Hoosiers can access the program as allowed under ACA with maximum leverage of Federal reimbursement dollars.

•The current design of the program also includes participant co-pays, which have proven expensive for providers and an administrative burden. Healthcare providers report that it often costs more to collect co-pays than to write them off. Many healthcare providers and nonprofit service providers are currently absorbing these costs to keep families enrolled in coverage. This practice would be impractical to continue for the expected large number of new enrollees.

•The proposed disenrollment process due to nonpayment of premiums results in an administrative cancellation of benefits and the inability of individuals to reenroll for 12 months. A grace period and appeals process needs to be incorporated into the plan.

•The Family Social Services Administration currently provides the HIP program for about 40,000 Hoosiers. The scalability of increasing the individuals served by this program to over 400,000 will lead to increased administrative needs and support.

For a copy of the press release, click here.

ICHS Press Release

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