May 15, 2014
Another conservative governor finds a way to expand Medicaid (JASON MILLMAN, May 15, 2014, Washington Post)
Posted by Orrin Judd at May 15, 2014 3:05 PMIt looks as if Indiana is about to join the list of red states signing up for Obamacare's Medicaid expansion. [...]Pence last year insisted that he would only expand coverage if he could do it through the Healthy Indiana Plan, a health savings account-type of program for about 45,000 adult Hoosiers who didn't qualify for the traditional Medicaid program.The Obama administration maintained that Indiana couldn't expand Medicaid through HIP because the program had an enrollment cap, and some cost-sharing features may have been problematic. HIP's design has been praised by conservatives for requiring Medicaid beneficiaries to be more conscious consumers because they take more financial responsibility for their care.It looked like HIP was at risk of expiring in 2013, but the federal Centers for Medicare and Medicaid Services and Indiana struck a deal last September to keep the program running through the end of this year. It gave both sides more time to negotiate on the Medicaid expansion, and it allowed people enrolled in HIP to keep their coverage in the meantime.Pence will lift HIP enrollment caps, opening up the program to working-age adults earning less than 138 percent of the federal poverty level ($16,105 for an individual or $32,913 for a family of four). Between 334,000 and 598,000 people will be covered under the plan, according to Pence's office. Enrollment will open in 2015, with federal approval. [...]The HIP deductible is increasing from $1,100 to $2,500, but Indiana is covering those extra costs. By comparison, the average deductible for a mid-level "silver" plan under the ACA is slightly higher than HIP's, at $2,907, according to to HealthPocket. And while Obamacare opponents have criticized high-deductible individual plans under the health-care law, Pence says the HIP high-deductible plans are an intentional design feature."Exposure to and awareness of the cost of care are key components of the consumer-directed model that encourages price and quality transparency from providers," according to a document Pence's office. "The increased deductible aligns with private market high deductible health plans paired with a health savings account, providing members valuable experience with a private market plan design."