INDIANAPOLIS – Hoosiers could soon get access to a new health benefit sharing plan run by the Indiana Farm Bureau – an innovative program lawmakers hope will help bridge the gap for the state's uninsured.
But don't call it insurance – it doesn't carry the same rules and requirements, the biggest of which it will be able to deny those with pre-existing conditions.
“It's not perfect but we have to do something,” said Sen. Andy Zay, R-Huntington – a co-author on Senate Bill 184. “A lot of farmers are falling between the cracks, so I think it's a very positive first step. We will have to evaluate how it and other plans might impact the overall market.”
Legislators easily passed the nonprofit agricultural organization coverage bill, and it is on Gov. Eric Holcomb's desk for his signature.
The Indiana Farm Bureau has hoped to get the program up and running for Jan. 1, 2021, but acknowledges that is up in the air due to the coronavirus public health emergency.
“The last few days have thrown a curve ball,” said Farm Bureau President Randy Kron. “It's another option to health insurance that will offer limited coverage for different health benefits and services.”
Rep. Martin Carbaugh, R-Fort Wayne, said the product is akin to pooling along the lines of a health care sharing ministry exempted from the requirements of insurance under the Affordable Care Act.
He said the product will look and feel a lot like insurance, including monthly premiums and a menu of coverage items. But because state law specifically carves it out of being insurance, the coverage doesn't have to cover a wide variety of illnesses or services.
Carbaugh, who chairs the House Insurance Committee, said the Indiana program is modeled after a Tennessee Farm Bureau plan that has been around for 20 years.
“We are not reinventing the wheel,” he said.
Carbaugh said the legislature did provide some parameters that the plan must cover – ambulatory or outpatient services, hospitalization, emergency services, and laboratory services. The plan cannot have an annual coverage limit of less than $2 million a year. Things such as prescription coverage and doctor visits will be up to the Indiana Farm Bureau – “but we have a strong level of trust in that organization and feel they will do what's best for their membership.”
Kron said anyone seeking coverage will undergo a health assessment and the plan can reject anyone.
That is where Zay said it becomes problematic because it could ultimately shift the sickest people to private insurance or the Affordable Care Act – which could impact the broader insurance pool.
“The insurance industry is concerned but it's a good opportunity to bring something positive to many people who have nothing at all right now,” he said.
Blue Cross Blue Shield has online warnings about similar programs including that there might not be negotiated discounts for medical care that insurance companies have.
And the plans have much less regulatory oversight than traditional plans.
Kron said Indiana Farm Bureau will partner with Tennessee, whose program offers five plans covering health, dental and vision services. There are a variety of deductibles including a high-deductible plan that meets the federal definition of a health savings account.
Only those who have been members of the Indiana Farm Bureau for 30 days are eligible. Kron said the annual membership fee is $32.50.
He said the organization is focused on helping the farm community but other small businesses or entrepreneurs could also find it an option. Kron stressed it is not for those who have employer plans or those subsidized on the exchange or anyone 65 or over on Medicare.