As Congress weighs repeal of the Affordable Care Act, the home state of Vice President Mike Pence Tuesday sought to keep its conservative-style Medicaid expansion under the federal health law.
Indiana to the Trump administration to extend a regulatory waiver and funding until Jan. 31, 2021, for its of incentives and penalties that are intended to encourage low-income Hoosiers on Medicaid to adopt healthy behaviors. Beneficiaries pay premiums, get health savings accounts and can lose their benefits if they miss payments.
Though the health law鈥檚 repeal, the Healthy Indiana Plan that he established in 2015 as the state鈥檚 governor has brought Medicaid coverage to more than 350,000 people. The architect of the plan was health care consultant , who has been nominated to head the Centers for Medicare & Medicaid Services.
Without Trump administration approval, federal money for Indiana鈥檚 expansion will run out Jan. 31, 2018. Indiana officials said the Medicaid expansion would continue even if Washington follows through on a Republican proposal to distribute federal Medicaid funds through a block grant program that would give states more flexibility in setting benefits and eligibility levels.
State officials refused to say whether the expansion would continue if Congress repealed Obamacare and eliminated funds for Medicaid expansions. If that happened, it鈥檚 unlikely states would have the money to make up for the lost federal aid.
Indiana鈥檚 effort to continue its Medicaid expansion demonstrates how states that expanded Medicaid under the Affordable Care Act 鈥 even Republican-controlled ones聽鈥 are counting on additional federal dollars to pay for those expansions. It also reflects deadline pressure: They can鈥檛 wait for Congress to finish its debate over the future of the health law because they need to set budgets and programs now for next year.
According to Indiana鈥檚 request, continuing the Medicaid expansion will cost Indiana $1.5 billion but bring $8.6 billion in federal funding from 2018 to 2020.
鈥淚ndiana has built a program that is delivering real results in a responsible, efficient, and effective way,鈥 Gov. Eric Holcomb, a Republican, said in a statement. 鈥淚 look forward to maintaining the flexibility to grow this remarkably successful tool and to preserve our ability to respond to the unique needs of Hoosiers.鈥
Several other states including Kentucky and Ohio are considering adopting features of Indiana鈥檚 Medicaid plan.
Tuesday鈥檚 filing continues most core elements of the Healthy Indiana Plan, but also expands beneficiaries access to substance abuse treatment and adds incentives for members to quit smoking, use chronic disease management programs and take part in voluntary job referral and training programs.
鈥淐ertainly I think the new administration would give the waiver a friendly reception,鈥 said Joan Alker, executive director of the Center for Children and Families at Georgetown University. 鈥淏ut again that doesn鈥檛 answer the question about whether the money is going away,鈥 if Congress repeals the health law and the Medicaid expansion.
Rep. Susan Brooks, R-Ind., broke the news of the waiver submission plans at a House committee hearing on Medicaid on Tuesday.
鈥淚t’s an outstanding program that I hope folks on both sides of the aisle see it is a way to save and help people who truly need it, and it can be replicated,鈥 Brooks said.
Some Republican plans to scrap and replace the Affordable Care Act don鈥檛 include a Medicaid expansion. Republicans have argued for years that the Medicaid program is broken and non-disabled adults who gained coverage under the expansion should not be covered.
Under expansion, states received additional federal funding to expand eligibility to everyone with annual incomes at or below 138 percent of the federal poverty level, or about $16,000.
Holcomb isn’t the only Republican governor counting on Medicaid expansion and the additional federal funding continuing at least through 2018.
Ohio Gov. John Kasich a budget Monday that maintains expansion coverage for 700,000 individuals.
But Kasich to switch from a traditional Medicaid expansion to a more conservative version that will require beneficiaries to pay more out of pocket.
