Health care professionals and advocates for the poor voiced praise and support Wednesday for a plan by Gov. Mike Pence to expand the state’s Healthy Indiana Plan to provide more insurance coverage to Hoosiers.
Pence plans to submit the plan – known as HIP 2.0 – by June 30 to federal officials, who will decide whether the state can use the program instead of traditional Medicaid for those poor adults who would otherwise be covered under the Affordable Care Act.
Kristen Metzger, plan president for Indiana Medicaid at Anthem Blue Cross and Blue Shield, said at a public hearing that the company fully supports HIP 2.0 and its design. Metzger reported that nearly 81 percent of people enrolled in the original HIP program said that they were satisfied.
“We have seen positive results,” Metzger said.
Katherine Wentworth, chief operating officer of MDwise, said the company also supports HIP 2.0’s promotion of personal responsibility and consumer-directed principles. Wentworth reported that more than 90 percent of HIP enrollees paid their portion of the contributions on time.
Paul Chase, deputy director for policy and administration at Covering Kids and Families of Indiana, said the group actively supported the original HIP, which launched in 2007 as an insurance program for poor Hoosiers. That was before Congress approved the federal Affordable Care Act.
But federal officials said HIP didn’t comply with the requirements under Obamacare. That led Pence to redesign the program to HIP 2.0.
“We applaud Gov. Pence for this ambitious plan and its approval,” Chase said. “We believe HIP 2.0 is a win-win proposal.”
Federal rules require the state to hold public hearings on the plan before it can be submitted for approval.
The next public hearing on the HIP 2.0 proposal is scheduled for 1 p.m. Thursday at the Indiana Statehouse, Room 156-B. However, people are welcome to send public comments through letter and email until June 21.
The new 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 $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 to be based on personal responsibility and consumer behavior.
Each plan includes a Personal Wellness and Responsibility, or POWER, account that helps pay for deductible expenses.
The three plans are called 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. The 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 to $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 the 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.