INDIANAPOLIS | With just three months until millions of low-income Americans start signing up for an expanded Medicaid program, the Pence administration revealed Tuesday it has yet to begin talking with the federal government about creating an Indiana alternative.
Debra Minott, Indiana's secretary of the Family and Social Services Administration, told the General Assembly's Health Finance Commission the governor believes preserving the Healthy Indiana Plan, which covers 37,316 participants, is a higher priority than negotiating a Medicaid alternative, which would cover some 400,000 Hoosiers.
"I think we are dealing with incredibly important and difficult issues and we're dealing with the lives of vulnerable people, and so I don't think we can just be lured by the fact there's a pot of money there without really being certain we're making good and prudent decisions," Minott said.
Republican Gov. Mike Pence has refused to expand Medicaid eligibility as directed by the Affordable Care Act, also known as Obamacare, because he believes the federal government will not keep its promises to adequately fund the program.
As a result, Indiana will give up 30,000 jobs and an estimated $10.45 billion in federal money that otherwise would be spent in the state through 2020, according to the Indiana Hospital Association.
Pence promised state lawmakers he would negotiate an alternative to Medicaid expansion that would be similar to HIP, which requires participants pay up to 5 percent of their incomes to access a federal- and state-supported, high-deductible health insurance plan.
But Minott said when she met with federal health officials last week she was instructed only to win permission to continue HIP beyond its scheduled termination at the end of the year.
"To go to CMS (Centers for Medicare and Medicaid Services) at the outset and start talking about expansion, it is not going to be a quick and easy discussion," Minott said. "He did not want to leave the current participants in the plan left hanging."
Minott said she is "optimistic" the federal government will approve Indiana's request to continue HIP for three more years.
As for the 400,000 Hoosiers set to be blocked from enrolling in traditional Medicaid and seemingly unlikely to have an Indiana alternative, Minott said they still have plenty of options to obtain health care.
"We will be making sure they are aware of the community health centers in their communities, free clinics that are available in multiple places around the state and other safety net-type resources," Minott said.
Under the Affordable Care Act, Medicaid eligibility will extend to Americans earning up to 133 percent of the federal poverty level, which is $14,856 for an individual or $30,657 for a family of four, in states that choose to expand.
Indiana will continue to require Hoosiers earn less than 22 percent of the federal poverty level — that's $2,457 for an individual or $5,071 for a family of four — to enroll in Medicaid.