In­di­ana’s Med­i­caid ex­pan­sion plan fac­ing new scru­tiny

Modern Healthcare - - REGIONAL NEWS - —Vir­gil Dick­son

In­di­ana of­fi­cials have not re­sponded to claims that they cooked the books when as­sess­ing the per­for­mance of the state’s Med­i­caid ex­pan­sion.

NPR re­ported that the state’s ap­pli­ca­tion to re­new Healthy In­di­ana Plan 2.0 had mis­lead­ing and in­ac­cu­rate in­for­ma­tion to jus­tify its ex­ten­sion be­yond the end date of Jan. 31, 2018. Staffers at the left-lean­ing Na­tional Health Law Pro­gram and Cen­ter on Bud­get and Pol­icy Pri­or­i­ties re­viewed the data and found it flawed.

The In­di­ana plan has been a model for other red states such as Ken­tucky and Ohio that are look­ing to gain fed­eral fund­ing for ex­pan­sion but aren’t nec­es­sar­ily on­board with the Af­ford­able Care Act-led ini­tia­tive. In­di­ana’s pro­gram was co-de­signed by Vice Pres­i­dent Mike Pence when he was gov­er­nor of In­di­ana and Seema Verma, Pres­i­dent Don­ald Trump’s pick to lead the CMS.

Un­der HIP 2.0, ben­e­fi­cia­ries pay pre­mium con­tri­bu­tions, have health sav­ings ac­counts, get in­cen­tives for healthy be­hav­iors, and face a ben­e­fit lock­out if they don’t pay pre­mi­ums. As many as 350,000 peo­ple are be­lieved to have gained ac­cess through the pro­gram.

Jim Gavin, a spokesman for the state’s Med­i­caid agency, did not com­ment on the false data claims but de­fended the model. He said the state has made sig­nif­i­cant progress on re­duc­ing the number of unin­sured as well as pro­mot­ing value-based care and per­sonal health re­spon­si­bil­ity.

The data sub­mit­ted, how­ever, was sup­posed to sup­port claims that HIP 2.0 is more suc­cess­ful than a straight­for­ward Med­i­caid ex­pan­sion with­out pre­mi­ums or health ex­pense ac­counts.

“On that ques­tion, we have seen no ev­i­dence that In­di­ana is per­form­ing bet­ter for low-in­come en­rollees,” said David Mach­ledt, se­nior pol­icy an­a­lyst with the Na­tional Health Law Pro­gram.

Vice Pres­i­dent Mike Pence

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