Despite all the partisan rancor that erupted with Obamacare, there has been refreshing bipartisan agreement on the success of Indiana’s HIP 2.0 program, which provides insurance to low-income Hoosiers using federal Medicaid dollars.
The program—an expansion of the Healthy Indiana Plan approved by the Legislature in 2007 at the urging of then-Gov. Mitch Daniels—serves 427,000 Hoosiers, all adults and all of them responsible for paying what are typically small premiums and co-pays.
HIP 2.0 was made possible by the Affordable Care Act, better known as Obamacare, which called for an expansion of Medicaid eligibility in all states. The courts ruled that federal officials couldn’t force states to implement that expansion and a number of states with Republican governors refused to do so.
Others, Indiana among them, opted for a more creative route. First, the Daniels administration and then Gov. Mike Pence’s administration negotiated for months with federal officials to let the state try something different. They proposed—and eventually won approval for—a program that used Medicaid dollars to offer a more traditional insurance product, one that requires users to contribute financially to the plans and their care in ways that Medicaid doesn’t.
The plan was not without its critics—on both sides of the political aisle. Many conservatives wanted Pence to refuse to participate in Obamacare at all and decline all Medicaid dollars. Liberals and many progressives wanted the state to expand Medicaid just as Congress had intended.
But out of that conflict came HIP 2.0, a program that a majority of Republicans and Democrats in the Legislature could get behind and have since celebrated. Hospitals and other health care providers like it. Insurance companies have readily participated by offering plans. And advocates for the poor say it has boosted the number of Hoosiers with health insurance.
Indiana’s current governor, Republican Eric Holcomb, is seeking federal permission to extend the program through 2021.
That’s why it’s such a shame that HIP 2.0 is now threatened.
The Republican-controlled U.S. House has already passed a bill that would scrap much of Obamacare and cut Medicaid funding—which could jeopardize funding for HIP 2.0 and force the state to restrict services, cap enrollment or eliminate the program. The Senate is debating its own version of the legislation.
Pence—now the country’s vice president—is urging the Senate to act soon to “repeal and replace” Obamacare, although lawmakers are still struggling with the details.
They need to struggle with these details. Lawmakers should resist the temptation to pass a law that would destroy programs such as HIP 2.0 that have found a way to balance liberal ideals about government serving the poor with conservative principals about the marketplace. That’s not in anyone’s best interest.
We expect Pence and our Indiana congressional delegation to be thoughtful about the way they proceed in this area. We want to see HIP 2.0 still standing when the smoke clears.•
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