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Pence, Sebelius to meet on health care expansion proposals

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Indiana Gov. Mike Pence is scheduling a meeting with U.S. Health and Human Services Secretary Kathleen Sebelius about the state’s request to use its own health care plan in place of a traditional Medicaid expansion.

Sebelius said in a letter received by the state Wednesday that her office is willing to work with the state to make the Healthy Indiana Plan comply with federal rules for expanded coverage. But she made clear that a number of HIP’s rules are not acceptable to federal officials.

Pence had requested the meeting in a letter Nov. 15. In her response, Sebelius did not mention an in-person meeting. But Pence’s staff said the offices are working to set one up for February when Pence will be in Washington, D.C., for a National Governors Association event.

I am grateful for the timely response from Secretary Sebelius and for her willingness to meet to discuss this matter further,” Pence said in a prepared statement. “We remain committed to good-faith negotiations with the Obama Administration to determine whether Indiana can use our proven consumer-driven health care model to expand health care coverage in Indiana.”

The federal Affordable Care Act required states to expand Medicaid so that it served more people with higher incomes. But the U.S. Supreme Court ruled that Congress couldn’t order the states to make the change.

Since then, Indiana has been trying to convince federal officials to let it use the Healthy Indiana Plan – which requires recipients to share the cost of health coverage – as its Medicaid expansion.

So far, federal authorities have only OK’d a one-year expansion of HIP. Sebelius said in her letter that the state will have to submit a request by June 30 to extend HIP beyond 2014.

But she said the federal law doesn’t allow Indiana to receive full Medicaid reimbursement for the plan because it requires some of the poorest Hoosiers to contribute to the cost of the insurance and puts caps on enrollment.

However, the secretary said new rules would allow the state to use co-pays for Hoosiers who earn more than the federal poverty level, which is $11,490 for a single person.

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  1. The deductible is entirely paid by the POWER account. No one ever has to contribute more than $25/month into the POWER account and it is often less. The only cost not paid out of the POWER account is the ER copay ($8-25) for non-emergent use of the ER. And under HIP 2.0, if a member calls the toll-free, 24 hour nurse line, and the nurse tells them to go to the ER, the copay is waived. It's also waived if the member is admitted to the hospital. Honestly, although it is certainly not "free" - I think Indiana has created a decent plan for the currently uninsured. Also consider that if a member obtains preventive care, she can lower her monthly contribution for the next year. Non-profits may pay up to 75% of the contribution on behalf of the member, and the member's employer may pay up to 50% of the contribution.

  2. I wonder if the governor could multi-task and talk to CMS about helping Indiana get our state based exchange going so Hoosiers don't lose subsidy if the court decision holds. One option I've seen is for states to contract with healthcare.gov. Or maybe Indiana isn't really interested in healthcare insurance coverage for Hoosiers.

  3. So, how much did either of YOU contribute? HGH Thank you Mr. Ozdemir for your investments in this city and your contribution to the arts.

  4. So heres brilliant planning for you...build a $30 M sports complex with tax dollars, yet send all the hotel tax revenue to Carmel and Fishers. Westfield will unlikely never see a payback but the hotel "centers" of Carmel and Fishers will get rich. Lousy strategy Andy Cook!

  5. AlanB, this is how it works...A corporate welfare queen makes a tiny contribution to the arts and gets tons of positive media from outlets like the IBJ. In turn, they are more easily to get their 10s of millions of dollars of corporate welfare (ironically from the same people who are against welfare for humans).

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