The state’s Healthy Indiana Plan has had general success in administering health care for uninsured Hoosiers between the ages of 19 and 64. Created in 2007, the program offers full health benefits including hospital services, mental health care, physician services, prescriptions and diagnostic exams. It requires minimal monthly contributions from the participant.
Most of its guidelines are being offered in a proposed expansion of Medicaid; 400,000 low-income residents would qualify. The federal government would take on most of the cost.
Don’t cringe just yet. Yes, it derives from President Barack Obama’s Affordable Care Act. That may be one reason the plan faced opposition from Gov. Mike Pence and Republicans in the Statehouse. They also don’t like the idea of adding 400,000 low-income, uninsured Hoosiers to the Medicaid rolls.
Republicans aren’t hopeful that the feds will carry through. Even though the federal government will cover 100 percent of the cost of new enrollees from 2014 to 2016, the share will decline in following years. And if that approach falls apart, Indiana might be forced to pick up the tab. Such reluctance is based on fear.
But if Indiana doesn’t join in — and it would not be the only state to reject the plan — then Hoosiers might face a higher penalty.
Indiana could receive $10.5 billion in federal aid in the next seven years. But expanding HIP could also cost the state close to $2 billion over that same period.
Under the Affordable Care Act, also known as Obamacare, states must expand Medicaid eligibility to Americans earning up to 133 percent of the federal poverty level, which is $14,856 for an individual or $30,657 for a family of four.
An Indiana resident currently must earn less than 22 percent of the federal poverty level — that’s $2,457 for an individual or $5,071 for a family of four — and have limited assets to enroll in Medicaid.
Last week, the Republican-controlled Senate voted 44-6 for Senate Bill 551, which allows the state’s Medicaid office to negotiate with federal health officials on the expansion. The state wants to control the program, determine which health services are provided and require the participation fee.
It might be more cost-efficient to let the feds administer Medicaid. Pence seems willing to go along with the plan if it is administered through Healthy Indiana. That sounds plausible, as long as state officials don’t try to impose overreaching and underachieving guidelines. Indiana needs to be in this plan. Low-income residents can’t be denied access to health services.
In summary
- Indiana should join the Medicaid expansion. Not doing so would prove to be fiscally irresponsible because of the loss of federal dollars.
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