Dive Brief:
- A day after Indiana's Republican Gov. Mike Pence applied to CMS for a waiver to bring 350,000 more Hoosiers under Medicaid, the Indiana Hospital Association on July 2 urged the agency to act swiftly.
- The new HIP 2.0 Healthy Indiana Plan would extend coverage to "working poor"—up to 138% of the federal poverty level—who fall in the coverage gap: outside income requirements to enroll in Medicaid, and below the level to qualify for exchange subsidies under the Affordable Care Act. The plan sets up a system of premium supports so workers can buy employer-sponsored coverage, and requires copays.
- IHA said its members will provide support for HIP 2.0 through an existing provider-fee program; this fee, plus tobacco tax revenue dedicated to the current Healthy Indiana Program, will help the state to qualify for billions of dollars in federal matching funds.
Dive Insight:
IHA said the governor's newly submitted waiver plan will provide better reimbursement to Indiana hospitals struggling to provide up to $3 billion in uncompensated care annually. In its plea for coverage expansion, the hospital group said 860,000-some Hoosiers, or 14%, are uninsured; and if the new plan is approved, the average family could save up to $677 in annual premiums.
Indiana’s plan bears some similarities to Iowa’s successful Medicaid waiver, which has limited premiums for people earning between 100% and 138% FPL. But critics worry about its approach and the harshness of certain "lockout" provisions for those not paying premiums. The Indianapolis Star reported June 20 that a clash with the administration over how soon to rollout the plan preceded the recent dismissal of the secretary of the Family and Social Services Administration, who urged waiting until next spring.
