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INDIANAPOLIS – Almost four months after the start of a new state program providing health insurance for the working poor, nearly 6,000 Hoosiers are enrolled and receiving benefits, prompting appreciative letters to pour into state offices.
But some correspondence has been more critical, pointing out problems in the program that lawmakers will likely examine this summer.
Judi Ettinger, of New Palestine in Hancock County, has tried numerous times to get her 19-year-old son enrolled in insurance plans but has been turned down because of a pre-existing condition.
So when she heard the Indiana General Assembly and Gov. Mitch Daniels had raised cigarette taxes in the 2007 legislative session to help uninsured Hoosiers she shrugged it off.
Then in January she heard several thousand Hoosiers were on the program and that the average premium was $100.
“I said, ‘What the heck. Let’s fill out an enrollment form.’ ” Ettinger recalled.
When she got the call that her son was approved “it made my day and his,” she said. Her son attends Ball State University.
And his premium, by the way, is $2 a month.
“One of the stresses in my life just got alleviated because of your Healthy Indiana Plan,” she wrote in a note to Daniels.
Her son is now one of almost 6,000 Hoosiers on the program. In all, more than 40,000 applications have flowed in with about 7,500 denied; 15,000 pending; 6,000 conditionally approved; and another 6,000 waiting to be processed.
Legislators approved enough funding to serve up to 130,000 Hoosiers.
Several segments of adults without disabilities ages 19 to 64 are eligible for the program:
•Parents or caretaker relatives of dependent children with family incomes up to 200 percent of the federal poverty level.
•Childless adults with family incomes less than 200 percent of the federal poverty level.
That threshold is $20,800 for a single person or $42,400 for a family of four, according to 2008 guidelines.
After getting in the program, Hoosiers receive free preventive services and must contribute a small percentage of their gross annual income to a $1,100 health savings account with the state covering the rest. If that account is depleted, there is an additional $300,000 in annual coverage.
Two plans are being offered: one from Anthem Blue Cross Blue Shield and another from MDwise with AmeriChoice.
Participants must be uninsured for at least six months and can’t be eligible for employer-sponsored health insurance.
But not every person is as happy with the program as Ettinger, including several with complaints about response time and a lack of doctors in the program.
Carol Karnes, of Osceola in St. Joseph County, similarly is trying to get insurance for both her sons, including one who is set to graduate Tri-State University next month and settle down with his fiancée in the Angola area.
He is a 24-year-old diabetic who needs insurance for his insulin while he is looking for a job in this tough economy, she said.
But she applied months ago and says she has not heard back from the Healthy Indiana Plan.
“I can’t wait 90 days to get him health insurance,” Karnes said. “It’ll be an expense on me.”
Several other Hoosiers who wrote letters also said they have waited two to three months for word.
Mitch Roob, secretary of the Indiana Family and Social Services Administration, said the state has 45 days to process an application “but if you are delinquent in getting us information it doesn’t count against us.”
He said the state was initially unprepared for the large influx of applications but has increased staffing to 90, though many of them had never worked in the system before and had a “steep learning curve.”
Roob said there are three main reasons for denial:
•People don’t meet the economic guidelines.
•They don’t pay the required premium.
•The applicants have access to employer-sponsored health care.
Roob believes this issue will be a big topic this summer when an interim study committee examines the progress of the program so far.
“That’s the piece of this that creates the largest problems,” he said. “We knew this would be an issue. We decided to err on the side of being conservative.”
One of the program’s primary authors, Rep. Charlie Brown, D-Gary, said he isn’t sure why people wouldn’t contribute to their own health care.
“I don’t know what brings on that kind of mentality that they want a totally free program,” he said. “This is mainly directed at people who work but don’t have access to insurance.”
Roob said that some employers offer insurance but sometimes at full cost to the employee, making it practically impossible to buy.
“I thought that creating the HIP plan was to help people who could not get/afford insurance,” one citizen from Silver Lake in Kosciusko County wrote to FSSA recently. “But I was recently turned down because I am eligible through my work even though the cost is outrageous and I can’t afford to get it through my work.
“I am extremely disappointed and feeling let down.”
Sen. Patricia Miller, R-Indianapolis, another primary author on the bill creating the program, said this is an important topic to tackle.
She also wants to expand the program so that Hoosiers making above 200 percent of the poverty level can buy into the program at full cost to them but remain in the same insurance pool, perhaps driving down premiums for all participants.
“Whenever you pass a law to do something new there are always areas that don’t work exactly the way you think they are going to work,” said Sen. Gary Dillon, R-Columbia City. “That’s why we meet every year.”
nkelly@jg.net
