The Healthy Indiana Plan 2.0 is now just over a year old. It’s Indiana’s version of the expanded Medicaid program offered by the Affordable Care Act. But unlike traditional Medicaid, Indiana received waiver approval for an alternate system that incorporates personal responsibility and consumer-driven health care. Here’s the theory: if one is financially engaged, it encourages a sense of ownership, personal empowerment, and responsible utilization of medical services.
Waiver approval was important since the expansion is almost entirely funded by the federal government. Before the expansion, Indiana Medicaid covered only low-income pregnant women, children, the disabled and parents below 24 percent of poverty; childless adults were excluded. Now, HIP 2.0 covers all adults below 138 percent of poverty. That’s nothing short of a sea change for Indiana.
I support the HIP 2.0 approach. It adds a small measure of financial responsibility but does not appear to discourage participation by the eligible poor. Actually, the personal financial contribution is negligible for the vast majority of HIP participants. If below the poverty level, participants can opt not to contribute to a HSA-like POWER account and pay small co-pays for medical services other than preventative services. If participants do contribute to the POWER account, they receive enhanced services and have no co-pays. The typical contributions are from $1 to a few dollars per month for the vast majority of participants. If between 100 to 138 percent of poverty, the personal contributions are moderately more substantial.
The HIP 2.0 program has been a great success and well received by patients. The Pence administration has aggressively encouraged participation through effective outreach; approximately 370,000 people are now covered, including 270,000 new participants and more than 5,300 new health-care providers. Seventy percent of participants have chosen to contribute to a POWER account. Emergency department visits by HIP recipients formally on Medicaid are reported to be down 40 percent, and patients appear more aware of the cost of medical care. HIP 2.0 has also been a godsend to Indiana hospitals, important economic and medical-care anchors for our communities, which are now seeing significant reductions in uncompensated care while facing reduced reimbursements from Obamacare.
Feldman is director of medical education and residency training at Franciscan St. Francis Health and a former Indiana State Health Commissioner.
Matt Lloyd
Deputy Chief of Staff, Communications and Strategy
Governor Mike Pence
317-864-0884 (cell)
All true….
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