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UPDATE: Pence unveils Healthy Indiana Plan expansion

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Indiana's effort to cover uninsured residents through a state-run health program instead of an expansion of Medicaid took another step forward Thursday when Gov. Mike Pence unveiled a proposal that he said would cover 350,000 residents if approved by the federal government.

Pence's "HIP 2.0" proposal is an altered version of the state's Healthy Indiana Plan, which currently provides health savings accounts to about 40,000 people. Indiana has been seeking federal approval to use the program, which was established in 2008 under former Gov. Mitch Daniels, as its vehicle to cover more uninsured residents.

Pence has long objected to an expansion of Medicaid, which he calls "broken" and a "fiscal monstrosity." Indiana has been seeking a waiver from President Barack Obama's health reform law to use the Healthy Indiana Plan instead, but federal officials have objected to some of the program's requirements, including a provision that recipients contribute the first $1,100 toward their care. A one-year extension of the Healthy Indiana Plan expires Dec. 31.

"Medicaid is not a program we need to expand," Pence said. "It is a program we need to change. Nobly created 50 years ago to help the poor and those with disabilities access quality health care, Medicaid has morphed into a bureaucratic and fiscal monstrosity that does less to help low-income people than its advocates claim."

The revised proposal, which Pence unveiled at Indiana University Health's Methodist Hospital in Indianapolis, would offer two tiers of coverage. The first would provide very limited coverage at little or no cost to those below 100 percent of the federal poverty level. A higher level dubbed HIP Plus would include dental and vision coverage, a comprehensive drug program and maternity services. Participants would pay $3 to $25 per month, based on income.

A third option would give workers who can't afford their employers' health care can help with their premiums from the state.

The proposal would use federal funds and expand the state's hospital assessment fee to cover the cost.

Pence said the expansion of the Healthy Indiana Plan would help low-income residents be personally responsible for their health, unlike traditional Medicaid. The plan also includes a program that will connect HIP recipients with state-sponsored job training and job search programs.

"HIP is not intended to be an entitlement. It is a safety net program that aligns incentives with human aspirations," Pence said.

He described his visits with patients around the state, including a woman named Diana who had held off going to the hospital for treatment because she lacked health care before.

"I think Diana is like a lot of Hoosiers who don't want a handout; they want a hand up," he said.

The proposal needs approval from the Centers for Medicare and Medicaid Services, which administers the federal health reform law. Pence said Indiana will submit its plan by the end of June.

Indiana Democrats, who have been asking Pence to expand Medicaid for well more than a year, gave the proposal a tepid response Thursday.

"I respect that this plan aligns with his personal beliefs, but I have serious concerns that it is an untested proposal that will still fail to provide critical health coverage to thousands of Hoosiers," said U.S. Rep. Andre Carson, D-Indianapolis, in a prepared statement.

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  • Common Sense
    This may be better than nothing, but Governor Pence's program can't even process applications within its own 45 day requirements now. About 60 days and still running here. How much worse will it be if this gets approved? Then HIP 2.0 has a work training requirement for people at or below 138% of poverty level and apply for the insurance. According to indeed.com the average police office in Indiana makes $25,000 a year. So, if I have a job making equivalent money that offers no health insurance than I have to get job training for affordable healthcare.
  • A Proven Approach?
    The link which describes HIP 2.0 has this quote: "The Healthy Indiana Plan uses a proven, consumer-driven approach that was pioneered in Indiana" All this concept has proven is that high deductible policies force low income families to avoid preventive care until they have to stumble into the emergency room. Consumer directed proposals assume consumers will become more price conscious and thus promote market efficiency. But Wall has presented evidence in this column that hospital prices do not reflect costs, rather they are set to maximize revenue. Unlike the proponents of this approach, these prices are not transparent.
  • Regifting?
    Sounds like someone just rewrapped Obamacare.
  • Personally responsible?
    This new program that Pence has come up with will make poorer Hoosiers "personally responsible" for their health?? In other words if they need medical care he's implying that it's their fault if they are sick. And it's kind of hard to exercise and eat expensive, healthy foods if you don't have enough money. Our governor has such a way of putting a zinger into something that is some times beyond most people's control and that is getting a disease or developing an illness. It's their fault that they are poor and their fault if they get sick. And if they need help and seek help why do the Republicans always label this as a "handout"? So what should they do exactly? Crawl off and die instead of seeking medical care? Callous attitude that only people who can afford to get sick are justified if they do. This is Christian?
  • Political Stunt
    Pathetic political stunt.
  • Political Stunt
    Pathetic political stunt.

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  1. A Tilted Kilt at a water park themed hotel? Who planned that one? I guess the Dad's need something to do while the kids are on the water slides.

  2. Don't come down on the fair for offering drinks. This is a craft and certainly one that belongs in agriculture due to ingredients. And for those worrying about how much you can drink. I'm sure it's more to do with liability than anything else. They don't want people suing for being over served. If you want a buzz, do a little pre-drinking before you go.

  3. I don't drink but go into this "controlled area" so my friend can drink. They have their 3 drink limit and then I give my friend my 3 drink limit. How is the fair going to control this very likely situation????

  4. I feel the conditions of the alcohol sales are a bit heavy handed, but you need to realize this is the first year in quite some time that beer & wine will be sold at the fair. They're starting off slowly to get a gauge on how it will perform this year - I would assume if everything goes fine that they relax some of the limits in the next year or couple of years. That said, I think requiring the consumption of alcohol to only occur in the beer tent is a bit much. That is going to be an awkward situation for those with minors - "Honey, I'm getting a beer... Ok, sure go ahead... Alright see you in just a min- half an hour."

  5. This might be an effort on the part of the State Fair Board to manage the risk until they get a better feel for it. However, the blanket notion that alcohol should not be served at "family oriented" events is perhaps an oversimplification. and not too realistic. For 15 years, I was a volunteer at the Indianapolis Air Show, which was as family oriented an event as it gets. We sold beer donated by Monarch Beverage Company and served by licensed and trained employees of United Package Liquors who were unpaid volunteers. And where did that money go? To central Indiana children's charities, including Riley Hospital for Children! It's all about managing the risk.

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