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Last updated: Tue. Sep. 17, 2013 - 07:07 am EDT

Indiana team wanted HIP extension before expansion

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INDIANAPOLIS — A top state official on Monday defended efforts to extend the Healthy Indiana Plan by a year rather than immediately expand Medicaid, explaining to lawmakers that it was federal officials — not Gov. Mike Pence — who pushed for changes to who qualifies for the state-run program.

Family and Social Services Administration Secretary Debra Minott took questions on the Healthy Indiana Plan two weeks after the federal Centers for Medicare and Medicaid Services signed off on a one-year extension and some sizable changes to the program, including a new limit on earnings.

The state will soon only accept residents earning up to 100 percent of the federal poverty, or $11,500 for a single adult. It now takes individuals earning up to 200 percent of the poverty level, although the program also has an extensive waiting list. The change, Minott said, should allow the state to increase enrollment from 35,000 to 45,000 low-income residents.

Pence originally sought to expand Medicaid under the federal health care law using the state-run plan, a move that would have covered more than 400,000 uninsured residents. But that request was delayed while the state negotiated a continuation of the plan, which had been operating under a federal waiver set to expire at the end of the year.

"The initial application we filed in April included expansion as a whole, and the governor requested that we deal with the issue sequentially because he was concerned that the negotiations may become protracted and that the current participants in HIP may be left hanging at the end of the year," Minott told members of the General Assembly's Health Finance Commission.

She later noted it was CMS officials who sought to lower the eligibility cap, not Pence officials. CMS didn't immediately respond to an email from The Associated Press seeking comment.

Opponents of expanding Medicaid say it would cost the state too much money, while supporters argue inaction will deprive Indiana of billions of dollars in federal aid.

Democratic lawmakers, vastly outnumbered in both the Senate and House, continued to raise their frustrations over the delay and a lack of clear answers from the Pence administration.

"It's very much of a concern," said Sen. Mark Stoops, D-Bloomington. "For instance, IU Health has announced it will have 800 layoffs. Part of that is because they're restricted based on provisions in the Affordable Care Act and because Indiana has not gone ahead and accepted the Medicaid expansion."

The Medicaid debate comes just ahead of the opening of the federal exchange residents will use to buy coverage. Indiana's federal-run exchange is set to open Oct. 1, and plans must be purchased by Jan. 1.


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