Indiana has become the 28th state — plus Washington, D.C. — to expand Medicaid under the Patient Protection and Affordable Care Act, according to The Wall Street Journal.
Indiana Gov. Mike Pence (R) has been seeking to expand his state's Healthy Indiana Plan, a state-sponsored health insurance program administered by private health insurers and available to adults ages 19 to 64 with incomes less than 100 percent of the federal poverty level who are not covered by Medicaid or other essential health coverage.
Gov. Pence claimed he would not expand Medicaid "unless he was allowed to charge some participants contributions toward the cost of their coverage and lock them out of the program for six months if they didn't comply," according to the report. That "pitted advocates for the traditional program against federal officials' desire to see the program grow," the report reads.
Under the deal that has been secured, new beneficiaries in the program earning below the federal poverty level — about $11,700 for a single adult — would have to contribute at least $1 per month, rising to $20, or be without benefits such as dental and vision care, Indiana aides told The Wall Street Journal. A person earning "a little above" the federal poverty level would have to pay a contribution starting at $20 a month, and if they get behind on payments, they might be locked out of coverage for six months, the report reads. Additionally, many enrollees will have copayments of up to $25 "for repeat inappropriate emergency room use," according to the report.
"Indiana has forged a new path forward for the states, and it's a new day for the Medicaid program," Seema Verma, a top adviser to the Gov. Pence, told The Wall Street Journal.
CMS Administrator Marilyn Tavenner and HHS Secretary Sylvia Burwell issued a statement commenting on expansion in Indiana.
"This agreement will bring much needed access to healthcare coverage to an estimated 350,000 uninsured low-income Hoosiers over the next three years," Ms. Tavenner said.
Ms. Burwell added, "I continue to be encouraged by interest from governors from all across the country who want to bring healthcare coverage to low-income people in their states by expanding Medicaid. They understand both the economic benefits of Medicaid expansion and the health and financial security it brings to their residents. The (Obama) administration will continue to work with governors interested in expanding Medicaid to devise approaches that work for their states while keeping faith with the law's goals and consumer protections."
The federal government will fully fund the expansion through 2016. Then beginning in 2017, federal funding rates gradually go down, but never fall below 90 percent of costs, according to the statement.
Coverage for new enrollees begins Feb. 1.
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