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A top state official told lawmakers on Wednesday that she expects federal officials to move quickly on the state's request to develop its own Medicaid expansion plan, but she said the Centers for Medicare and Medicaid Services will likely seek to negotiate changes to Indiana's proposal.
Debra Minott - the secretary of the Indiana Family and Social Services Administration
- said convincing federal authorities to let Indiana try a consumer-driving program as its way of expanding health care to 400,000 Hoosiers is her top priority.
She told the House Public Health Committee that the goal will be expanding health coverage, not expanding Medicaid in its current form as called for by the federal Affordable Care Act.
"We don't want to leave an impression we're expanding a broken system," said Minott, who has been on the job at FSSA for just four weeks. She's the first official from Republican Gov. Mike Pence's administration to testify on a Medicaid expansion bill.
Committee Chairman Ed Clere, R-New Albany, said he pushed for Minott to testify because lawmakers have "received mixed message on where the administration stands on expansion."
"I think we cleared up some of that today," Clere said. "Obviously the administration has a key role in this and I'd like for it to be as collaborative as possible."
Lawmakers are trying to decide how - or whether - the state should proceed with an expansion of Medicaid, a joint state-federal program for low-income families. Currently, Indiana has some of the tightest income requirements for adults, meaning that only the state's poorest Hoosiers qualify.
The federal Affordable Care Act
required states to expand coverage to more adults. But the U.S. Supreme Court ruled last year that Congress couldn't force states to participate.
Still, federal officials are offering to pay 100 percent of the cost of health care for new recipients for the first few years of an expansion. And many states - even some with GOP governors that opposed the federal health care law - are moving forward with expansions.
Pence has said he would consider providing coverage to more Hoosiers if the state could do so through the Healthy Indiana Plan
, an existing program for low-income adults that requires patients to pay part of the cost of coverage. But he hasn't committed to doing so.
His administration has asked federal authorities to send Indiana its Medicaid money as a block grant and then let the state remake its program to be more like the Healthy Indiana Plan. Federal officials are waiting on more information from the state before considering the request.
Minott said she expects a negotiation over what any final plan would include. And she suggested that the General Assembly doesn't need to act for her office or the governor to do that negotiating.
Still, she told the House Public Heath Committee that Senate Bill 551
- legislation already passed by the Senate and now under consideration in the House Public Health Committee - gives the Pence administration the flexibility it needs to proceed.
Clere said after the meeting Wednesday that lawmakers should participate in the debate but he wants to give Pence broad flexibility.
"This is a major policy decision," Clere said. "And I'll be disappointed if the legislature decides not to weigh in with substantive and meaningful legislation."
The committee plans to debate and vote on the bill next week.
Lesley Weidenbener is managing editor of TheStatehouseFile.com, a news service powered by Franklin College journalism students and faculty.