INDIANAPOLIS — The third prong of Gov. Mike Pence’s health care initiative got little attention last week – state premium assistance that would allow workers to access their employer’s health insurance coverage.
The Healthy Indiana Plan would be expanded in multiple ways under a waiver the state is seeking from the federal government.
But the HIP Employer Benefit Link is especially unique.
“Our proposed HIP 2.0 would offer HIP Link, which is a premium assistance program for people who have access to insurance through their employers, but who may not be able to afford it,” Pence said. “This is a first in the nation.”
Together, the three levels of HIP coverage are the benefit link, the basic plan and the plus plan.
All use a health savings account with financial cost-sharing for the participant.
“This is a program that really is about expanding opportunities to working Hoosiers up to a certain level who for all intents and purposes as a practical matter don’t have access to affordable health insurance today,” Pence said. “This will create a framework where those Hoosiers will be able to obtain coverage they might not otherwise be able to afford and thereby provide for themselves and their families.”
Brian Neale, health care policy adviser for Pence, said many of Indiana’s uninsured earning up to 138 percent of the federal poverty line – about 100,000 Hoosiers – actually have access to health insurance at their jobs. But they can’t afford it.
That’s where HIP Link comes in.
He said anyone eligible for HIP can choose the basic, plus or link plan. The income limit would be about $16,100 for an individual and $32,900 for a family of four.
All HIP-eligible adults with access to employer- sponsored insurance will receive options counseling through an enrollment broker regarding which plan is best suited for the individuals needs and situation, the plan said.
“The goal here is really to provide more choices for HIP members,” Neale said. “If they would like to participate in private market employer-sponsored plan HIP link really offers them that opportunity.”
Under Link, the person would receive a defined contribution account that could be used to pay for the employer plan premiums, deductible, co-payments or other costs.
The account would be between $4,000 and $4,500. The participant would also have to make a monthly contribution of between $3 and $25 to the account depending on the participant’s income.
For every missed monthly contribution, $50 will be deducted from the account’s balance.
“The concept sounds good, but I don’t know the details yet of how it’s going to play out,” said Mike Ripley, vice president of health policy for the Indiana Chamber of Commerce. “I think we generally support it.”
He has received some basic information on the component but is awaiting a more detailed presentation.
“We think anything that allows Hoosiers to have coverage – especially through their employer – is a good step,” Ripley said.
The chamber will review the waiver proposal and file formal comments during the next 30 days.