INDIANAPOLIS | Gov. Mike Pence is expected to announce Tuesday the federal government has approved Healthy Indiana Plan 2.0 as an alternative to Medicaid expansion under the Affordable Care Act, also known as Obamacare.
The exact details of who will be eligible for HIP 2.0, what it will cover, who will pay and when coverage might start still are not known ahead of the Republican's 9 a.m. region time speech at an Indianapolis hospital campus.
State leaders and federal health officials have spent nearly seven months negotiating components of the program. A key sticking point has been Pence's insistence on HIP 2.0 participants paying a monthly premium to maintain health coverage.
The governor's office would not say Monday what changes finally led to an agreement.
Under Pence's original proposal, between 350,000 and 450,000 able-bodied Hoosiers ages 19 to 64 who earn less than 138 percent of the federal poverty level — that's $16,243 for an individual or $33,465 for a family of four — would be eligible for the HIP Plus plan.
Those participants, who otherwise would have been able to enroll in no-cost Medicaid, instead would be required to contribute between $3 and $25 a month, based on their incomes, to a health savings account the program will bring up to $2,500.
A member's annual health care costs, including vision, dental and prescription drug services, initially would be paid from that account, with the program covering all expenses beyond $2,500.
But if an enrollee failed to make a health savings account contribution, he or she would be dropped to HIP Basic, which offers reduced benefits and requires co-payments for all services. Depending on income, some delinquent participants would lose their HIP coverage altogether.
A third tier of the program, HIP Link, would allow HIP-eligible working Hoosiers to use their health savings accounts to pay their share of costs associated with an employer-provided health plan.