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Pence tells feds that HIP 2.0 has broad support

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State officials say they will submit a plan Wednesday to expand the Healthy Indiana Plan to more uninsured Hoosiers using federal Medicaid dollars.

The plan – which Gov. Mike Pence has dubbed HIP 2.0 – could offer health insurance to as many as 350,000 people in Indiana. But the U.S. Department of Health & Human Services must approve the proposal before the state can put it into action.

In a letter submitting the waiver request, Pence said the plan offers a “broader set of consumer-driven health care choices.”

And he told federal officials that the proposal “has achieved an exceptional level of bipartisan support from a wide array of health care consumers, stakeholders, and legislators in our state.”

Originally, officials from the Family and Social Services Administration, the agency that would administer the plan, said they would submit the waiver request by midnight Monday.

But later, the governor’s office said the state only submitted its request to extend the current Healthy Indiana Plan to federal officials on Monday. That plan covers 45,000 Hoosiers and is operated under an existing waiver that must be renewed. The deadline for that submission was midnight Monday.

But the state did not face the same deadline for its HIP 2.0 proposal, said the governor’s press secretary, Kara Brooks. Now, the state intends to submit the HIP 2.0 proposal on Wednesday.

The state recently ended a 30-day formal public notice and comment period during which Hoosiers reviewed the waiver for the expansion of the Healthy Indiana Plan and submitted comments to the state.

The Healthy Indiana Plan began in 2008 under a five-year waiver from the federal government and was continued by two one-year waivers granted in 2012 and 2013.

Now, the state wants to use the revised version of HIP as a replacement for a Medicaid expansion called for by the federal Affordable Care Act.

The plan would apply to all non-disabled adults ages 19-64 who earn between 23 percent and 138 percent of the federal poverty level. In 2014, that means a maximum income of no more than $16,105 annually for an individual and $32,913 for a family of four.

HIP 2.0 would provide three plans for low-income Hoosiers. The options are meant promote personal responsibility and consumer behavior.

Each plan includes a Personal Wellness and Responsibility, or POWER, account that patients use to help pay for deductible expenses.

The three plans are Employer Benefit Link, Plus, and Basic.

The Employer Benefit Link plan provides financial support to members who wish to access employer-sponsored insurance options. The plan gives Hoosiers greater choices and increases access to providers while encouraging the use of existing private insurance options.

Individuals who are deemed eligible can pick an employer-sponsored plan that they think works best for them. Enrollment in this plan is optional.

The Plus plan is a consumer-driven Medicaid alternative for Hoosiers with incomes below 138 percent of the federal poverty level. It is available to all members who make their monthly POWER account contributions, which range from $3-$25 per month. Members and the state jointly fund a $2,500 POWER account, which members contribute to based on an income scale.

Plus offers enhanced benefits, such as vision and dental services and includes comprehensive prescription drug benefits. It also covers maternity services with no cost-sharing during the duration of the pregnancy.

The Basic plan is the default for Hoosiers that fall below 100 percent of the federal poverty level and fail to make required POWER account contributions. It requires co-payments for all services.

Basic plan members will use the state-funded POWER account to cover their $2,500 annual deductible. There is a reduced benefit package and a more limited prescription drug benefit.

The basic plan will provide incentives for members to be more cost-conscious and to recommend preventive care services.

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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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