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Policy & Politics
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.

Experts Weigh Indiana's Medicaid Fate Under Proposed GOP ACA Replacement

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The House Republicans’ replacement plan for the Affordable Care Act—otherwise known as Obamacare—would gradually phase out enrollment in Medicaid expansion programs such as Indiana’s Healthy Indiana Plan.

The bill—released earlier this week—aims to let the expansions remain for another three years. Starting in 2020, enrollment would “freeze,” and no new enrollees would be able to join, which would mean the program would gradually lose members.

Approximately 250 thousand people currently have coverage through HIP 2.0.

Georgetown University Center for Children and Families Executive Director Joan Alker says when it comes to health crises such as the state’s opioid epidemic, pulling HIP funding could lead to some ugly consequences.

“Either they’re going to have to raise taxes to cover growing needs, or these very vulnerable populations will have to fight it out against each other for these declining funds,” she says.

Indiana University health economist Kosali Simon says not only does the GOP’s plan scrap HIP funding, it also places a cap on how many federal Medicaid dollars states can receive.

“I think what the states are going to be thinking about is: how much less is this than what we used to get, and what does this mean for how solid a social safety net Medicaid remains?”

Alker calls the proposal a one-two punch.

“This will result in huge costs increases that Indiana will have to shoulder on its own,” she says. “It’s a double whammy, because in addition to rolling back the Medicaid special match rate, the entire Medicaid program is capped.”

Indiana officials have said previously the Hoosier State’s involvement in the Medicaid expansion is predicated on receiving federal assistance, which further throws the future of HIP 2.0 into question.

A spokeswoman for Governor Eric Holcomb’s calls the plan a good first step, adding the state will continue to work on a replacement for and pursue improvements to the HIP program.