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In Indiana, we look out for one another.
This is why we take our Medicaid program so seriously: We want to ensure resources are available for the truly needy who depend on them.
However, our Medicaid program is in trouble, and we must act now so it can continue supporting Hoosiers in need. Senate Bill 2, a priority for Senate Republicans, will do just that.
Our Medicaid program faces two major problems.
The first is an unsustainable rise in costs. As the second-largest line item in our state budget, rising Medicaid costs threaten other state budget priorities like schools, public safety and lower taxes. We must start slowing this growth rate or risk cutting programs and services that positively affect all Hoosiers.
Second, a federal court recently struck down the Healthy Indiana Plan waiver—the agreement Indiana has with the federal government to use a unique approach to deliver an alternative to Medicaid for low-income Hoosiers who are able-bodied adults. This court decision guts the HIP program and creates a conflict with state law. We must address this, or Indiana could face more legal challenges and have little control over Medicaid’s unsustainable growth.
SB 2 proposes a few simple reforms that would address these issues.
Importantly, it closes loopholes to stop fraud and waste in Indiana’s Medicaid program, which spends millions each year on Medicaid enrollees who are ineligible. This improper payment rate is one of the nation’s highest, at nearly 30%, meaning nearly 30 cents of every dollar spent involves some sort of payment error.
Our bill will take steps to ensure Indiana Medicaid dollars go to individuals who qualify and no one else.
Historically, Indiana hasn’t double-checked whether some enrollees are eligible when they sign up for Medicaid. SB 2 will require the state to verify eligibility by checking a person’s income, residency and household size before enrolling them and to verify that lottery winners, individuals with significant assets and nonresidents aren’t receiving Indiana Medicaid benefits.
The bill will also raise standards for hospitals enrolling individuals in Medicaid. Currently, hospitals can presume someone is eligible for Medicaid without verification. SB 2 will strengthen the Medicaid enrollment process by sanctioning hospitals that repeatedly approve ineligible individuals.
SB 2 will also add mechanisms to the program that will help Hoosiers build healthy, secure futures. It implements an enrollment cap for HIP and requires able-bodied enrollees to work at least part time to remain eligible. These reforms will protect the HIP program, making it sustainable for the long haul and bringing it in line with state law.
Hoosiers support these reforms, too. Polling shows that majorities of likely Indiana voters support verifying eligibility before enrolling Medicaid applicants and reviewing Medicaid rolls at least twice per year to verify recipients are still eligible. And nearly two-thirds support requiring able-bodied adults to work, train or volunteer at least part time to qualify for Medicaid.
If we don’t act now, Medicaid costs will continue to rise—partly from unchecked waste and fraud—leaving fewer dollars for the truly needy. With Medicaid eating up more and more state funds, Indiana will inevitably have to cut expenditures in other areas, like public safety and education.
However, SB 2 offers Indiana’s Medicaid and HIP programs a brighter future—one in which resources are available for those who truly need them—not those defrauding the system—and where other budget priorities won’t be sacrificed for out-of-control Medicaid costs.
Now is the time to put our Medicaid program back on course for the future.•
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Garten, a Republican from Charlestown, is the Senate majority floor leader. Mishler, a Republican from Mishawaka, is chair of the Senate Appropriations Committee.
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