Republican Indiana Gov. Mitch Daniels -- who was tapped to present the GOP response to the State of the Union -- is mounting what he calls a last ditch effort to extend the state's Medicaid 1115 waiver called the Healthy Indiana Plan, which is slated to expires in 2012 but the state wants to use as part of the Medicaid expansion in 2014. A spokesperson in the governor's office says that the state wants a response as soon as possible, but definitely by mid-year, in order to know if the program will be available for the 350,000 to 500,000 Hoosiers expected to be newly eligible for Medicaid under the health law.
This year the Indiana legislature passed a bipartisan law calling for the Healthy Indiana Plan (HIP) to be the coverage vehicle for the Medicaid expansion in 2014, Daniels wrote in his Dec. 28 letter. "Our intent is to make HIP a permanent part of our Medicaid program. However, due to the delinquent release of regulations, your agency was unable to respond to our original request to amend our State Medicaid Plan, he says, adding, and "This waiver submission is our final attempt to save the HIP program."
Daniels argues that the HIP has proven to be "far superior" to traditional Medicaid. The plan is available to certain individuals earning less than 200 percent of the poverty level. The plan provides a POWER account of $1,100 per adult to pay for medical costs, to which contributions are made by the state and the individual based on a sliding scale of ability to pay. The plan also includes a basic benefit package once medical costs exceed the $1, 100 and free preventative services such as annual exams, smoking cessation and mammograms, according to the HIP website.
Daniels says that more than 99 percent of the people in the HIP would re-enroll in the plan, and says that members have lower non-emergency emergency room use than traditional Medicaid, higher generic drug use, and over 97 percent of participants pay their contributions on time.
Due to the federal law, Indiana will absorb between 350,000 and 500,000 new Medicaid participants, and will ultimately service almost a fourth of the state's population. Daniels says that, should the Supreme Court uphold the Medicaid expansion, "our state's leadership believes that new Medicaid participants should not be consigned to a traditional paternalistic program that fosters dependency, raises costs, and does not improve health outcomes."
While advocating for passage of the health law, President Obama said "if you are happy with your insurance you can keep it," Daniels writes. "We are hopeful that you will prove that the administration will honor that commitment by granting our request," he says.