The Possible Grim Future of HIP 2.0 Indiana Health Insurance Coverage for Low Income Hoosiers

HIP 2.0, an expansion of Indiana’s Medicaid program that requires low-income Hoosiers to have “skin in the game” by contributing financially — is up in the air, causing hospitals and other health providers to fret it could be decimated. It’s been called one of the biggest success stories in Indiana health care, adding more than 400,000 Hoosiers to health insurance rolls and earning strong bipartisan support.

Republicans in the U.S. Senate are continuing to work secretly on a bill that could repeal the Affordable Care Act, which funds the plan, while giving few details on how the bill would affect Medicaid programs. Under Indiana law, if federal funding dries up, HIP 2.0 would revert to the original Healthy Indiana Plan, with enrollment caps of 35,000 and the likelihood of a long waiting list. Indiana is one of 32 states that have expanded their Medicaid program through the Affordable Care Act. Last year, the federal government gave Indiana $1.8 billion in Medicaid money to fund HIP 2.0, and the state chipped in another $100 million, using money from Indiana’s cigarette tax revenue and through fees assessed on hospitals. The federal funds accounted for 95 percent of the cost.

The Medicaid expansion has allowed IU Health to treat tens of thousands of additional low-income patients, including those who for years had neglected chronic conditions such as diabetes and cancer. Many had to forego care (before HIP 2.0) because of the cost until they became so sick they could wait no longer, which often resulted in their needing expensive services for health problems that would have been easy to treat if they had received care sooner,” said Ryan Kitchell, IU Health’s executive vice president.

Outside metropolitan areas, HIP 2.0 has helped small hospitals provide basic services such as emergency care and maternity care, said Brian Tabor, president of the Indiana Hospital Association. “Rural providers have said expanding coverage has been absolutely critical to being able to keep the doors open,” he said.

Indiana Republicans warned in March that repealing the Affordable Care Act could unravel a vital health program for the poor in their state. Republican Todd Young has said “it’s essential” to maintain the Medicaid expansion — or at least create the ability for the state to maintain the Medicaid expansion, according to the Muncie Star Press.Republican Gov. Eric Holcomb said in March he had not “seen a more successful program” than HIP 2.0. But just weeks later, he announced his support for the GOP health bill to repeal and replace Obamacare — a move that would threaten federal funding. His spokeswoman, Stephanie Wilson, declined to say what Indiana might do to keep the program fully funded if the U.S. Senate goes along with the House in repealing Obamacare and cutting Medicaid funding.

reporting from Indiana Business Journal

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