INDIANAPOLIS – About 100 people came out for a public hearing Wednesday on Gov. Mike Pence’s plan to cover more uninsured low-income Hoosiers, but only five spoke in support.
And two of those were from companies that would benefit financially. No one spoke in opposition to the proposed HIP 2.0 expansion.
Written comments are being accepted on the state’s federal waiver request until June 21. A few dozen have been received so far.
Pence wants to use Indiana’s existing Healthy Indiana Plan to expand coverage to 350,000 uninsured Hoosiers rather than traditional Medicaid. But the Centers for Medicare and Medicaid Services must first agree for Indiana to receive billions from the Affordable Care Act.
The state share of the costs would be covered by cigarette taxes and a hospital fee.
HIP is considered consumer-driven health care because it requires a financial contribution via a health savings account from those receiving services while Medicaid is free. HIP also has a required preventive care component.
Katherine Wentworth, chief operating officer of MDwise, said her company covers 11,500 Hoosiers currently on the limited HIP program.
She said it’s the right vehicle to expand because it promotes personal responsibility. She noted that HIP participants are engaged in their health care – from reading email statements to getting breast cancer screenings and staying on top of chronic diseases. Wentworth said any expansion should keep emergency room payments because those have been effective in reducing ER visits.
Kristen Metzger, of Anthem, also supported the proposal. Her company covers thousands of HIP participants as well.
“We support HIP 2.0 as a replacement for traditional Medicaid,” she said, noting HIP has better health outcomes than Medicaid. “Clearly HIP has made a difference in thousands of Hoosier lives.”
Traditional Medicaid in Indiana covers people earning up to 22 percent of the federal poverty level.
Many states have expanded Medicaid under the Affordable Care Act to cover those making up to 138 percent of the federal poverty level, or $16,105 for individuals and $32,913 for a family of four.
Those between 100 percent and 400 percent of the federal poverty level can access tax credits to help them pay for health insurance through the federal exchange.
Because Indiana has declined to expand Medicaid it has left hundreds of thousands of people between 22 percent and 100 percent of the federal poverty level with no coverage options at all.
Pence’s program is two-tiered.
Anyone below 100 percent of the federal poverty line would be placed in the HIP Plus plan. This requires a monthly contribution to the POWER account of between $3 and $25 depending on income. It also provides access to dental and vision coverage, less treatment limitations, a better prescription plan and no co pays.
But if a person doesn’t pay the monthly contribution to the health savings account they get defaulted to the HIP Basic plan, which has reduced benefits, more prescription restrictions and no dental or vision coverage. Most importantly it requires co pays for all health care services except preventive and family planning services.
Those between 100 percent and 138 percent go to HIP Plus automatically. If they don’t make their monthly contribution their coverage is suspended for six months. There is no access to the basic plan in this income level.
Paul Chase, deputy director of Covering Kids and Families of Indiana, said HIP has helped 117,000 Hoosiers since its inception and has more than 46,000 currently enrolled.
He said expanding HIP to coverage more Hoosiers empowers them to make better health decisions.
“It has the potential to greatly improve the health of our citizens and our economy,” Chase said.
Comments can also be submitted by mail to:
Indiana Office of Medicaid Policy and Planning
Attn: Steven Holt
402 W. Washington Street Room W374
Indianapolis, IN 46204