Low enrollment numbers in the Healthy Indiana Plan are questioned

As Indiana seeks federal approval to continue its Healthy Indiana Plan, a health insurance program for income-eligible uninsured Hoosiers, some state legislators are concerned enrollment in the program is not higher.

Family and Social Services Administration Secretary Debra Minott provided an update on HIP Tuesday during the first meeting of the Legislature’s Health Finance Commission.

The state has applied to the Centers for Medicare & Medicaid Services to continue the HIP program as an ongoing waiver project. Recently, Minott and members of her staff, along with members from Gov. Mike Pence’s office, met with CMS Director Cynthia Mann.

Although the state has proposed using the HIP program as the platform to expand Medicaid, Minott told the commission the first priority is to get the current waiver approved so the enrollees in the program would have certainty their healthcare coverage would continue.

Minott said CMS had some concerns over issues such as benefits and enrollment caps but she is optimistic the program will get approval.

“We were very encouraged that yet this summer we will know and we will be able to communicate with the current HIP enrollees that their coverage will not be lost,” Minott said.

As of May, the HIP program had 37,000 Hoosiers enrolled with another 53,000 on the waiting list, according to Minott. The trust fund which supports the program contains a little over $300 million.

Both Sen. Vaneta Becker, R-Evansville, and Rep. Charlie Brown, D-Gary, pointed out when the program was originally enacted, enrollment was estimated to hit 140,000. They questioned why the current number of participants is so low, especially since the money to handle more enrollees is available in the trust fund.

Minott responded that enrollment in the HIP program is capped and that acceptance of more participants has to be done in a fiscally responsibly manner. She said she expects enrollment will rise if the program gets approval to continue for another three years.

“You talk about you’re doing this now and yet the funding has been there,” Becker said. “So to me, it’s been, I guess, an opportunity lost for people that need health coverage.”

Rep. Pat Bauer, D-South Bend, then pressed Minott over the expansion of Medicaid under the Patient Protection and Affordable Care Act. The federal health care plan calls for states to raise the eligibility for the program to 133 percent of the federal poverty level in order to give more people insurance coverage. However, states are not obligated to expand Medicaid.

During the 2013 legislative session, some Democratic legislators did push for the state to opt to grow Medicaid, arguing since the first three years of the expansion would be fully funded by the federal government, Indiana would essentially be losing tax money is if did not approve the expansion.

However, their efforts did not gain traction. Many other legislators, including those in the Republican leadership, were skeptical the federal dollars would be there to support the expansion.

Minott said the state is continuing to pursue the possibility that it be allowed to expand Medicaid under the terms of HIP. In particular, Indiana wants the participants in the expanded Medicaid to pay into the program like they do for the Healthy Indiana Plan.

“I think we are dealing with incredibly important issues and we’re dealing with the lives of vulnerable people,” Minott said. “And so I don’t think we can just be lured by the fact that there’s a pot of money there without really being certain that we’re making good decisions and treating these folks with the respect that they need. The last thing I want to do is treat them like a yo-yo.”

This was the first of five meetings the Health Finance Commission is scheduled to hold. It will convene again July 22 and discuss, among other topics, health care exchanges.