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State senator sees Medicaid solution

– Senate Health Chairwoman Pat Miller said Friday that Indiana’s health savings account program should be used to meet the requirements of the new federal Medicaid expansion.

Miller, R-Indianapolis, is drafting a proposal that would expand coverage using the Healthy Indiana Plan and ask the federal government to cover the cost.

It also would set guidelines for “navigators” required under the federal law to help residents use the insurance exchange once federal officials have set it up in Indiana.

The Healthy Indiana Plan “contains a lot of the things I think are important for consumers, including wellness and personal responsibility for their health as well as some financial responsibility, which would be a co-pay or some kind of premium based on income,” Miller said.

Gov. Mike Pence has all but shut the door on running a “hybrid” insurance exchange with the federal government, and he said this week that the only way he would sign off on a Medicaid expansion would be if it met same the terms laid out by Miller in her new amendment.

Throughout the debate, the growing cost of Medicaid has towered over the number of uninsured residents in Indiana as a breakpoint for any expansion.

Milliman Inc., the actuary hired by former Gov. Mitch Daniels to assess how the law would affect the state, has floated a series of eye-popping cost estimates over the last few years.

The firm estimates that a full expansion, for all residents earning up to 133 percent of the federal poverty line, would carry a cost of $2.6 billion over the next seven years.

The U.S. Supreme Court allowed Medicaid expansion last year in its ruling upholding the constitutionality of the federal health care law. The law gives states the option to accept the expansion, refuse it or postpone a decision.

But there are benefits for states that choose to expand Medicaid now: The U.S. government will pick up the entire cost in the first three years and 90 percent over the long haul.

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