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Reaction to HIP Expansion Shifts After Crossing State Lines

Bipartisan praise in-state, but some conservative think tanks skeptical

Gov. Mike Pence ( file photo: Eric Berman)

Governor Pence's proposal to replace Medicaid with an expanded Healthy Indiana Plan has brought compliments and criticism from unexpected places.

Several conservative think tanks have slammed Pence for accepting Obamacare's broadened Medicaid eligibility -- the Foundation for Government Accountability scoffs at the use of the Healthy Indiana Plan as "free-market window dressing." Pence says the reaction inside Indiana has been enthusiastic on both sides of the aisle, something he says he hopes federal officials will note when they consider whether to approve Indiana's request for a waiver from standard Medicaid rules.

Pence says he's encouraged by positive comments at last week's required public hearings, and notes state health commissioner William VanNess and other administration officials have been traveling around the state for more informal sessions explaining the plan.

Pence is proposing to increase eligibility from the poverty line to 38% above it, while introducing a new stripped-down coverage plan for people who don't want to set money aside in the health savings accounts HIP relies on. Unlike the primary HIP plan, the no-frills plan would require co-payments for health services. And Pence has proposed a state premium subsidy through HIP for people who want their employers' insurance plans but can't afford them.

Pence says the expansion is financially sustainable, even after full federal funding is cut back to 90% in 2020. The Indiana Hospital Association has pledged $50 million to plug the gap without a tax hike.

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