The working poor. They are Hoosiers with jobs, sometimes more than one job, living paycheck to paycheck.
Hundreds of thousands of those folks could not afford health care before former Gov. Mike Pence agreed to use Medicaid funding — expanded under the Affordable Care Act — to broaden the Healthy Indiana Program in 2015. Pence’s action created HIP 2.0 in 2015. Obamacare provides 90 percent of HIP 2.0’s funding.
The state’s version of Obamacare remains packed with political irony. Pence ardently fought former President Obama’s health care initiatives, along with every other type of initiative, refusing to accept the ACA’s traditional Medicaid expansion. While his resistance withheld coverage from thousands of Hoosiers for a year, Pence managed to collaborate with the Obama administration to develop an expansion of Medicaid, with an Indiana twist. HIP 2.0 requires recipients to make monthly contributions to a health savings plan.
Pence won praise for the adaptation of Obamacare, including from Obama himself. The former governor, now Donald Trump’s vice president, does not reciprocate that praise for the former president. Nonetheless, HIP 2.0 has improved the health circumstances for more than 400,000 Hoosiers.
Current Gov. Eric Holcomb wants to see those Indiana residents continue to receive health care coverage. The future of HIP 2.0 and other states’ Medicaid expansion programs are threatened by a U.S. House Republican plan to repeal and replace the ACA with the American Health Care Act. An analysis by the nonpartisan Congressional Budget Office projects that 14 million Americans would lose coverage in 2018, if the ACA is dismantled and replaced by the cleverly named AHCA. By 2026, the number would grow to 24 million, the CBO reported Monday.
Holcomb emphasized his support for corralling federal spending. Yet, he is asking Congress not to strip away funding for the health care coverage that low-income residents receive under HIP 2.0.
“I want to make sure that we’re compassionate and cover the Hoosiers that we are right now,” Holcomb said Monday, according to an Associated Press report. “I completely believe we need to fix the Affordable Care Act, and [the House Republicans’] repeal was the right first step, but the devil is always in the details.”
Thirty-one states will expand Medicaid coverage under Obamacare by 2026, the CBO projected, bringing coverage to an estimated 80 percent of newly eligible residents, the Washington Post reported. If repealed and replaced by the House Republican plan, none of those 31 states would follow through with their Medicaid expansions because the states would have to pay a much larger share of the cost.
The federal deficit would shrink by $337 billion through the next decade, and wealthy taxpayers would pay less, but fewer working poor in Indiana could get health care. Plus, older Americans overall will pay “substantially more” for health care, the CBO said.
Holcomb said HIP 2.0, the plan molded from Obamacare by Vice President Pence, works as well as any in the country. It should be used as a model while the ACA is repaired, instead of becoming a shrunken casualty as the ACA is dismantled. “I do think that HIP 2.0 is part of that answer in how our nation can address the issue of health care,” the governor said.
Congress should abide by Holcomb’s call for continued, proper federal funding for HIP 2.0.