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State’s handling of expanded Healthy Indiana questioned

Nobody spoke in opposition to the proposed expansion of the Healthy Indiana Plan at a public meeting conducted Monday by state officials.

But audience members urged the state to simplify the insurance application process, ease customer payment methods and solicit input from social-service advocates if federal authorities approve the plan for extending health coverage to 350,000 low-income Hoosier adults starting next year.

Fred Gilbert, a retired welfare caseworker, wondered whether the state is up to the task. The current version of HIP provided coverage to 42,000 people as of two weeks ago.

The Indiana Family and Social Services Administration “is utterly unable to handle it at this point,” Gilbert said about the expansion that Gov. Mike Pence has labeled HIP 2.0.

State Medicaid Director Joe Moser did not dispute Gilbert’s contention.

“I would agree with you that we’re not ready for this today. We rolled this out three weeks ago,” Moser told Gilbert.

“It’s going to take a massive effort on all our parts,” Moser said. “I can tell you that we’ve started to put together a plan that I’m very confident is going to succeed.”

About 50 people attended Monday’s meeting at Ivy Tech Community College Northeast. It was the eighth in a series of nine public events and two public hearings that began May 29.

HIP 2.0 would become available in 2015 if the U.S. Department of Health and Human Services deems it a suitable alternative to a federally recommended expansion of Medicaid, the public health insurance program for low-income people.

HIP 2.0 would require recipients to share in insurance costs through an income-based contribution of $3 to $25 a month in a “plus” plan or co-payments for medical care in a “basic” plan. There also would be a “link” plan in which workers could receive state assistance to buy employer-provided insurance.

Several times Monday afternoon, state health Commissioner Dr. William VanNess referred to the program as “consumer-driven.” It also would be paid by federal funds, cigarette tax revenue and hospital fees.

Mary Haupert, chief executive officer of the nonprofit Neighborhood Health Clinics, told VanNess and Moser that HIP 2.0 must be easy for people to enroll in.

“That’s going to make or break the program,” she said.

The current HIP is “a very complicated process” for applicants, Haupert said, “and there aren’t enough navigators anywhere to cover all the people. That (350,000) is a big number.”

VanNess replied: “We are definitely preparing for that. … We are used to signing people up. As cumbersome as it may be, at least it’s a process that’s in place that can be improved upon, I’m sure.”

HIP 2.0 would become part of the state’s Medicaid enrollment process, Moser said, “and the whole thing will be streamlined and simplified” and include standardized applications.

One audience member who identified herself as a former nurse said she had been stymied in her efforts to enroll.

“I don’t even know what to do next,” she said.

Because of a 45,000-participant limit, the current HIP will stop taking childless adult applicants beginning July 1.

Local chiropractor George Joachim wondered whether HIP coverage excludes chiropractic care.

Moser told him that coverage was denied first by state legislators and then by administrators, who cited high cost estimates, but that people who are considered “medically frail” would be eligible for chiropractic treatment under HIP 2.0.