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An opioid epidemic. High smoking rates. Health care provider shortages. Indiana faces serious public health challenges. Side Effects Public Media provides in-depth coverage of these issues and more.

Amid Uncertainty About National Health Policy, Indiana Asks To Extend Its Medicaid Expansion

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Statehouse of Indiana in Indianapolis

In 2015, Indiana expanded its Medicaid program under the Affordable Care Act. The Healthy Indiana Plan, or HIP 2.0, extended coverage to about 250,000 low-income Hoosiers who were not previously eligible. Amid the turmoil in Washington over what to do with Obamacare, Indiana has applied to keep the program running for three more years.

Susan Jo Thomas, director of health care advocacy group  Covering Kids and Families, says Indiana’s application to extend the regulatory waiver and funding for HIP 2.0 demonstrates the state’s enthusiasm for Medicaid expansion. “I think it shows that the state is trying to stay the course,” Thomas says.

If approved, the waiver extension would alter HIP 2.0. For instance, it would add a surcharge for tobacco users, and add incentives for addiction treatment. It would even add chiropractic benefits.

“That shows me that they’re listening and that they’re open to new ideas,” says Thomas.

The program’s signature innovation will remain in place. That is the requirement for enrollees to make monthly payments to maintain their coverage. Some health care advocates say while they are glad to see Medicaid expansion continue, they think this provision needs to be reassessed.

Fran Quigley heads the Health and Human Rights Clinic at the McKinney School of Law. He says requiring these monthly payments reduces enrollment and needlessly causes people to lose coverage. (If you miss a payment, you can be locked out of coverage for six months.) And he says it makes HIP 2.0 more costly to run, which goes against the program’s conservative roots.

“This is just more government and more bureaucracy, and a huge waste of taxpayer dollars,” Quigley says.

State reports show from August to October last year 4,621 enrollees above the poverty line got kicked off of their coverage for failing to pay a premium. 

The extension application will soon be up for public comment period of 30 days.

Jake Harper is an investigative reporter for Side Effects Public Media, and he is a co-host of the Sick podcast. He can be reached at jharper@wfyi.org.