Two separate waitlists overseen by the Family and Social Services Agency have been likened to crises by critics, delaying much-needed health and child care services to Hoosiers in need.
And now FSSA has added a third waiting list for applicants seeking child care services under the Child Care Development Fund and On My Way Pre-K.
The vouchers support low-income families earning less than 150% of the federal poverty level, or roughly $45,000 for a family of four. Many low-income families couldn’t afford child care without such subsidies and would instead drop out of the workforce, halting their professional development and no longer contributing to a community’s economy.
The agency has provided several updates to its waitlist for Medicaid waiver services, programs that are critical for Hoosiers seeking assistance as they age and for Hoosiers with disabilities. After starting the list earlier this year — and increasing the number of Hoosiers invited off each month — more than 12,000 Hoosiers are still waiting, including 4,617 Hoosiers on the Health and Wellness Waiver and 7,611 seniors on PathWays.
What’s up with child care vouchers?
Enrolled families will continue to receive child care vouchers “as long as funding permits,” according to the release, and a reassessment will start in the next federal fiscal year in October.
Several Democratic lawmakers from both chambers decried the move, which is the first time FSSA had employed a waitlist since 2018.
House Minority Leader Phil GiaQuinta, D-Fort Wayne, pointed to the lack of affordable options for parents and lamented the shortage of providers.
“This waitlist is a result of all federal childcare funds being used to their capacities here in the state. If you recall, Republican leadership told us recently that Hoosiers shouldn’t look to the state to solve this monumental problem,” GiaQuinta said in a statement, linking to a story from WRBI. “Now, tens of thousands of families risk losing access to childcare. As state lawmakers, we can’t continue to shrug our shoulders and tell Hoosiers to wait for the federal government to come to their aid. It’s time we put in the work.”
GiaQuinta vowed that his caucus would focus on child care — something he previously criticized Gov.-elect Mike Braun for omitting from his legislative agenda.
Sen. Shelli Yoder likened the new waiting list to “a moral failure and fiscal disaster,” pointing to the Republican majority’s decision to expand private school vouchers to nearly all Hoosiers in the last budget session rather than putting funds toward early childhood education.
“We’re telling a family of four earning up to $230,000 that they qualify for a need-based private school voucher, while a family earning $38,000 doesn’t qualify for a Pre-K voucher. That’s not just unfair—it’s absurd,” Yoder, D-Bloomington, said in a release.
In its release, FSSA pointed to the number of recent changes implemented by the General Assembly earlier this year, including the decision to expand subsidy funding to child care employees explicitly and raise the eligibility level — moves that came without extra funding.
More than 70,000 children have benefited from CCDF while nearly 8,000 children enrolled in pre-K programming, according to the agency.
Waitlists can serve two important functions, said Sam Snideman, the vice president of government relations for United Way of Central Indiana. Firstly, they can manage scarce resources but waitlists also signal to decision makers “how much demand there is for a particular good or service.”
Child care is one of the three priorities for the organization ahead of the 2025 legislative session, alongside action on housing and medical debt. Roughly six out of every ten children who need child care have access, with a shortage of services that costs the state an estimated $4.2 billion annually in missed tax revenue and employee shortages.
“… child care and pre-K services are really critical to the ability of the adults in a child’s life to work and to be economically productive, which means it’s also critical to the proper functioning of the broader macro economy,” Snideman said. “When we don’t have access … we’re really holding back — not only these kids and the sort of educational development that happens in those settings — but also the economic opportunity and prosperity for their families.”
The legislature took limited, non-budgetary action earlier this year but Snideman said early childhood education advocates always knew 2025 would be a big year.
“So much of the American Rescue Plan and other COVID-era supports from the federal government were going away,” Snideman said. “We’ve been using those funds in ways that sort of supported expansion and enrollment … to support and stabilize the sector from the provider perspective and from the family perspective.”
Budget writers have warned that funds will be tighter during the 2025 session, in which the General Assembly will craft Indiana’s next two-year budget. But Snideman said legislators will have to provide adequate resources for child care funding, “and that is not going to be cheap.”
“I think all of us who do advocacy are trying to be thoughtful about budget asks and mindful about the competing priorities,” Snideman said. “Certainly, the legislature has an unenviable task.”
Building upon a pilot model from earlier this year, the group also proposes pursuing a “tri-share” model in which the government, employers and individuals split the costs of child care. Michigan and a pilot in northeast Indiana have been early pilots of this model and shown some preliminary success, Snideman noted, but Indiana’s model could be tailored for specific economic groups or sectors.
The Medicaid waiver waiting list
Dozens of Hoosiers have publicly shared their waiting list experiences, including elderly Hoosiers who spent down their financial resources in order to qualify for Medicaid. Needing help and anticipating Medicaid assistance, they moved into assisted living — only for the bill to come due as they sat on the waitlist.
In addition to providing for assisted living expenses, the Medicaid waiver also covers other home- and community-based services, such as attendant care, adult day care, home-delivered meals or structured family care.
A coalition pointed to the recent reorganization of Medicaid services, including the introduction of managed care, and the program’s $1 billion shortfall. In return, FSSA made a series of unpopular decisions to curtail certain services and introduced the Medicaid waiver waitlist.
“… the State made abrupt and drastic changes to the Indiana Home and Community-Based Waivers — now called the PathWays Waiver and the Health and Wellness Waiver—neglecting to consult key stakeholders and failing to consider the short-term and long-term effects on Hoosiers and the Indiana State budget,” the coalition of organizations said in a release last week.
Members include AARP Indiana, The Arc of Indiana, the Indiana Assisted Living Association, LeadingAge Indiana, elder law attorneys and more.
Some Hoosiers have turned to the courts for relief, accusing the state of “failing its mandatory duty under federal law to ensure” that such services are available in a class action lawsuit filed in October.
Eamon Kelly, one of the attorneys representing the plaintiffs, pointed to a Friday order from the judge setting an aggressive schedule for proceedings.
“We appreciate the Court setting a prompt schedule on our Motion for Preliminary Injunction.
The FSSA waitlist is unlawful. The FSSA is denying seniors access to assisted living that it should be approving promptly under federal law,” Kelly told the Indiana Capital Chronicle.
Because the suit is class action, it seeks to provide relief to all elderly and disabled Hoosiers, though more Hoosiers are waiting than the state has federal permission to assist.