Senior Policy Analyst
Several states are considering adopting features of the federal waiver through which Indiana has expanded Medicaid — such as setting up accounts modeled on health savings accounts for each beneficiary, delaying coverage until beneficiaries pay premiums tied to their incomes, and ending coverage for some beneficiaries if they don’t pay their premiums. But Indiana has had trouble implementing its waiver, our new paper explains. Evaluations of the program — called the “Healthy Indiana Plan 2.0” (HIP 2.0) — are underway, and the Centers for Medicare and Medicaid Services should see the results before allowing other states to replicate it.
Indiana said it would use its waiver to test several hypotheses on how premiums affect participation in health coverage and the efficient use of health services. A robust body of research already shows that premiums harm low-income people. If Indiana isn’t implementing its waiver in a way that’s consistent with its agreement with federal officials, HIP 2.0 isn’t a true test of those hypotheses.
Indiana claims that it reached out to all providers that could participate, yet only 41 percent participated in the most recent quarter, and the vast majority of HIP 2.0 enrollees haven’t benefited from a presumptive eligibility period.