The Wholesome Indiana Plan is being prolonged for 10 years
Indiana has received federal approval to continue its plan for a healthy Indiana for another decade. This makes Indiana the first state to receive a 10-year extension for its Medicaid expansion alternative.
The extension is due to the fact that more Hoosiers have been added to the health insurance plan than ever before. More than 572,000 low-income residents in Indiana are getting their health insurance through the plan, about 100,000 more than at that time last year, officials of the Indiana Family and Social Services Administration said.
Typically, states only get two or three year extensions to their Medicaid alternatives.
In the past seven months, the plan has seen its largest enrollment to date. The plan was also an integral part of the state’s response to the changing economic circumstances resulting from the pandemic.
“Where would that be now without it? I think we’d really hurt, “said Dr. Jennifer Sullivan, FSSA secretary. “This is not a limited program. … I think that’s why it’s so important that we have it now. “
During the public health emergency, the state suspended any cost-sharing that some plan beneficiaries may have to contribute to their care.
The 10 year extension will give Indiana additional time to gather data on the programs offered under the plan and evaluate how well they are performing, Sullivan said. If the state sees opportunities for improvement, it can apply to the federal government for an exemption to make changes.
“This really gives us an interesting dichotomy between security on the one hand and flexibility on the other,” said Sullivan.
This is part of the philosophy behind allowing federal waivers for Medicaid expansion programs, federal officials say.
The Healthy Indiana Plan, launched in 2007 by then-Governor Mitch Daniels, had a limit on the number of people who could enroll at one point in time. The program provided benefits from the outset while also requiring beneficiaries to contribute, if nominally, to participation.
Following the passage of the Affordable Care Act in 2010, Indiana applied to the Obama administration for approval to convert HIP into the state’s Medicaid expansion program.
Months later, the state received approval to expand the program to all eligible adults.
One of the people charged with granting the 10-year waiver was Seema Verma, Administrator of the Centers for Medicare and Medicaid Services, who, as an advisor to the state, played a key role in shaping the original program.
“Government innovation is an opportunity to test ideas to help us achieve our ultimate goal of better health and wellbeing, and we encourage the states to continue to work with us, as Indiana has done, to tailor their programs to meet their unique needs “said the US Department Alex Azar, secretary for health and human services, in a press release. He’s Verma’s boss.
The latest federal government approval also included a five-year extension for substance use and mental illness treatment programs that 88,000 Indiana residents have participated in with all forms of Medicaid.
However, it is unclear what will happen to the Healthy Indiana Plan if the Supreme Court dismantles the Affordable Care Act or critical parts of it when it hears a lawsuit against the law next month.
“We worry every day,” said Sullivan.
Republicans gathered three years ago to try to repeal and replace the law, but they failed. This proved dry running for the state family and social services administration to come up with a number of plans for how to respond to keep the program alive, Sullivan said.
In its first decade, the Indiana Healthy Plan has improved the well-being of many Hoosiers, state officials say. In 2018, the plan included more than 545,000 preventative visits, and members are receiving record numbers of mammograms and vaccinations.
HIP Maternity, which provides free health services to expectant mothers, including dental and behavioral health services, grew 41% from 2015 to 2018. More than half of births in the state go to mothers on Medicaid.
Although one must be a citizen or have papers to be legal in the US to enroll in the state Medicaid program, the FSSA also provides emergency services to expectant mothers who do not have legal papers, Sullivan said.
In a sign that all of these efforts could pay off, the state announced earlier this month that Indiana child mortality had dropped to its lowest ever level in 2019.
And the FSSA continues to develop new programs. One of the most controversial is the Gateway to Work program, which includes what some call a work mandate. Last year the FSSA put this on hold after a federal lawsuit was filed against it. This lawsuit is still pending.
Even without the lawsuit, now would not be the time to take such action, Sullivan said.
“The right time to test is at a time of economic stability,” she said. “That time of opportunity is not now.”
The pandemic has also put another, possibly more popular, program on hold. The HIP Workforce Bridge program approved in June willAllow individuals moving from government assistance to employer insurance to continue using their Healthy Indiana Plan accounts, as they might with a health savings account.
Contact IndyStar reporter Shari Rudavsky at [email protected] Follow her on Facebook and Twitter: @srudavsky.