Feds approve work rules for HIP 2.0, more addiction funding

As many as 130,000 of the 400,000 people now covered by the Healthy Indiana Plan 2.0 will be required to work, take part in school or training, or do community service to continue receiving insurance benefits in 2019 through the Medicaid-funded program.

The requirements are part of a three-year extension of HIP 2.0 announced Friday afternoon by newly confirmed U.S. Health and Human Services Secretary Alex Azar.

Many of those 130,000 people already have jobs, Azar said during a press conference at Eskenazi Hospital, the city’s major “safety net” hospital for under-insured patients.

Others will receive services aimed at moving them into education, work or volunteer programs to keep them eligible for benefits.

“We’re building this with an intentional goal of having zero people have their benefits suspended,” said Jennifer Walthall, secretary of the Indiana Family and Social Services Administration, which administers HIP 2.0. “We will build this program thoughtfully and communicate it clearly.”

State officials said the remaining people on the program—about 270,000 participants—qualify for one of many exemptions, which waive the work requirement for those who are older, medically frail or have small children.

The Medicaid extension also makes Indiana eligible for as much as $80 million in additional federal funding annually for addiction treatment and expands the types of programs Medicaid recipients can use. The expanded options will include inpatient, outpatient and residential treatment and will be available to HIP 2.0 participants as well as Hoosiers who receive traditional Medicaid services.

Treatment, especially for opioid addicts, has been provided “in bits and pieces until now,” Walthall said. “This is about giving them access to more hospitals and facilities.”

Gov. Eric Holcomb had requested federal permission to make changes in HIP 2.0—including the work requirements, which mean able-bodied recipients must work in at least 20 hours a week or enroll in a work-readiness program. Such requirements aren’t currently required under the federal Medicaid program.

But President Donald Trump’s administration signaled that it was open to requests from Indiana and other states to experiment with work requirements. Last month, Kentucky became the first state to win a waiver and implement the changes. Indiana is the second.

Azar said 11 other states have also proposed new community-engagement requirements.

“There’s a great deal of excitement” about the programs, Azar said.

HIP 2.0 is Indiana’s version of the Medicaid expansion made possible under the Affordable Care Act. The original Healthy Indiana Plan launched in 2007 under then-Gov. Mitch Daniels and was among the first Medicaid-funded programs in the nation to require participants to pay part of the cost of care.

“Today’s announcement is just one significant step in a long legacy of innovation in person-centered health care that stretches back across three Indiana governors,” Azar said.

The plan covers Indiana residents between the ages of 19 and 64 whose family incomes are less than 138 percent of the federal poverty level and aren’t eligible for Medicare or another Medicaid program.

Azar was confirmed Jan. 24 as Trump’s second HHS secretary. He previously spent 10 years as a senior executive at Eli Lilly and Co. and drew criticism after Lilly raised the price of insulin and other widely used medications during his tenure.

Trump's first health chief, former Rep. Tom Price, R-Georgia, resigned last fall amid an outcry over his use of costly private charter aircraft for official travel.