Answer on Indiana Medicaid plan could take some time

The head of the state Family and Social Services Administration said Tuesday that the federal government is expected to approve an extension of the Healthy Indiana Plan, but a request to use the plan for an Indiana Medicaid expansion could take much longer.

FSSA Secretary Debra Minott told members of the General Assembly's Health Finance Commission that the state's health care leaders were encouraged following a meeting with federal officials June 20. Minott said Gov. Mike Pence directed her and others to ensure those already enrolled in HIP are secure before negotiating an expansion through the program.

"His instructions were: 'Your first priority is to take care of this group. Once you've taken care of this group. Then we can commence the discussions using the Healthy Indiana Plan as the platform,'" she said.

Roughly 40,000 low-income residents are enrolled in the program, which operates under a federal waiver. But the waiver is set to expire at the end of the year, potentially leaving enrollees without coverage.

The strategy answers the question of "What will happen with those already enrolled in HIP?" but pushes back the answer on whether Indiana will expand Medicaid.

Pence resubmitted an application with the Centers for Medicare and Medicaid Services in April seeking to use the state's hybrid health savings account plan as the vehicle for Medicaid expansion. CMS rejected an earlier request from former Gov. Mitch Daniels, citing concerns about the premium paid by members and a need for improved coverage.

A CMS spokeswoman said no decision has been made yet on the state's proposed expansion.

The expansion would cover residents earning up to 138 percent of the federal poverty level, but could cost the state billions more over the next seven years. The Medicaid expansion had been mandated under the federal health care law, but the Supreme Court ruled last year that states could not be forced to expand the program.

Pence ardently opposed the expansion using traditional Medicaid but he has said he would consider an alternative that gives the state more control over the program's operations and demands more responsibility of the enrollees.