The groups gathered last week at the Statehouse represented an incredibly diverse group of people and organizations – doctors, older Hoosiers, hospitals, mental health centers and kids.
But they had one message – and it was aimed at the federal government: Approve the state’s HIP 2.0 low-income insurance program.
It’s not clear whether the Centers for Medicare and Medicaid Services got the message. After all, the event was in Indianapolis – understandably, given where the groups are all located – and CMS is of course in Washington D.C.
But given how fast a tweet flies across the web, it’s hard to believe some folks in that massive agency didn’t hear about it. Whether they do anything about it is up in the air.
And that matters to thousands of lower-income, uninsured Hoosiers – as many as 350,000, according to advocates of the plan.
It’s understandable why approval might take awhile. Indiana Gov. Mike Pence – and the Republican-majority legislature – opted against expanding traditional Medicaid, which was authorized by the federal Affordable Care Act. Pence says that Medicaid doesn’t work and GOP fiscal leaders say it’s too expensive to implement.
So while Indiana officials debated what to do, thousands of Hoosiers who would otherwise have qualified for Medicaid under an expansion have gone either without coverage or were forced to pay more for their care.
During that period, the Pence administration was talking with federal officials – a debate that had started under previous Gov. Mitch Daniels – about whether Indiana could use its existing Hoosier Indiana Plan to serve more Hoosiers, in place of a Medicaid expansion. Of course, the state wanted to use Medicaid dollars to do it.
When that conversation went nowhere, Pence introduced a revamped plan – which he called HIP 2.0 – that is sort of a compromise between Medicaid and the state’s low-income health insurance program. Skeptical advocates for the poor were surprised to learn they didn’t mind the idea so much. And it was apparently close enough to Medicaid to lead some conservatives to criticize Pence for even suggesting it.
The plan would apply to all non-disabled adults ages 19-64, who earn between 23 percent and 138 percent of the federal poverty level. In 2014, that means a maximum income of $16,105 annually for an individual and $32,913 for a family of four.
HIP 2.0 would provide three plans for low-income Hoosiers, which have different levels of coverage and cost. But a key is that all participants would take on some responsibility for tracking their health care costs. And the more an individual is willing to contribute to costs, the better coverage he or she can get.
No one thinks the plan is perfect. I don’t think anyone believes Medicaid is either. But it’s certainly a credible proposal – one that deserves a thorough review.
Most importantly, folks without coverage in Indiana should know soon whether federal officials think the proposal is good enough. And if it’s not, officials in Indiana – and all those special interest groups – need to know that too.
Lesley Weidenbener is executive editor of TheStatehouseFile.com, a news website powered by Franklin College journalism students.