Holcomb still waiting on federal approval for Healthy Indiana Plan work mandate

Gov. Eric Holcomb speaks to reporters Nov. 29 in downtown Indianapolis. He said the state still is working to secure federal approval to add a work requirement to health coverage provided through Healthy Indiana Plan 2.0.

INDIANAPOLIS — The federal government has yet to approve Gov. Eric Holcomb's plan to require some Indiana Medicaid recipients be employed or seeking work as a condition of receiving health coverage.

The Republican told reporters Wednesday that state officials were in Washington, D.C., meeting with their federal counterparts about Holcomb's idea to impose a work mandate on approximately 130,000 Hoosiers served by Healthy Indiana Plan 2.0, also known as HIP.

Holcomb said the state's request, submitted to the federal government in July as part of its application to renew HIP through 2021, is not a done deal.

However, the governor declined to specify what the holdup is. Federal authorization for the entire HIP program expires Jan. 31, 2018.

"We're working on it," he said. "We're working on it."

A spokesman for the U.S. Centers for Medicare and Medicaid Services said the agency does not comment on decision timelines.

Under Holcomb's plan, an able-bodied adult who fails to work at least 20 hours a week in eight months of the year would be suspended from HIP until the person satisfies the employment requirement for at least one month.

The mandate would not apply to some 300,000 HIP members who already meet the work requirement, are full- or part-time students, pregnant women, primary caregivers for young children or disabled dependents, older than 60, medically frail, temporarily disabled, in a drug treatment program or recently released from prison.

HIP members unable to find work still could satisfy the mandate and preserve their health coverage by participating in verified job skills training, job search activities, vocational training, community service or volunteer work.

Holcomb said the mandate is needed to ensure Indiana has "a healthy workforce" to meet the demand for "approximately 1 million new skilled workers to replace retiring baby boomers and fill jobs being created by Indiana's dynamic economy" over the next decade.

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However, it's not clear how many HIP participants actually will find gainful employment, since state records show approximately 40 percent have not earned a high school diploma.

An actuary retained by the Indiana Family and Social Services Administration estimates that a quarter of the HIP population subject to the work requirement, or about 33,000 Hoosiers, will choose not to participate, and thereby lose their health coverage.

HIP is Indiana's version of the Medicaid expansion authorized by the 2010 Affordable Care Act, also known as Obamacare.

The federal government this year pays 95 percent of health care costs for HIP participants and 94 percent in 2018, with the state picking up the remainder.

CHIP still in limbo

Separately, the Republican-controlled Congress has yet to renew funding for the Children's Health Insurance Program, or CHIP, after allowing it to lapse on Sept. 30.

Absent legislative action in December, 11 states — California, Oregon, Idaho, Nevada, Utah, Arizona, Ohio, Mississippi, Pennsylvania, Connecticut and Hawaii — could be forced to terminate health care coverage for children from low-income families by the end of the year, with another 21 states due to run out of money for the program in early 2018.

The Indiana Family and Social Services Administration projects the Hoosier state will be able to continue its CHIP program until mid-2018 before it also runs out of funds.

More than 100,000 Indiana children are covered by CHIP through Hoosier Healthwise, including 6,489 children in Lake County, 1,660 in Porter County and 1,529 in LaPorte County, according to FSSA.

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