Embrace second opinion on HIP 2.0

Last year, Indiana’s plan for expanding health care under the Affordable Care Act for low-income Hoosiers, HIP 2.0, was approved by the federal government.

HIP 2.0 — a bigger, more ambitious version of the Healthy Indiana Plan — is Gov. Mike Pence’s alternative to straight expansion of Medicaid, which he describes as “broken.” Indiana became the fifth state to receive a waiver from the federal government. The wait for approval was long, but once approved, Indiana moved quickly to expand health care coverage to uninsured low-income Hoosiers.

In the year since HIP 2.0’s launch, the bottom line is clear: 270,000 Indiana residents who wouldn’t have qualified for Medicaid or Obamacare now have coverage.

That’s reason to celebrate, whether or not you favor all aspects of the consumer-driven plan. Participants in HIP 2.0 are required to make monthly contributions from $1 to $25. A Hoosier in poverty who doesn’t contribute is put in a “basic plan” with fewer benefits. Indiana was the first state to get permission to bar some adults from re-enrolling for a period of time if they don’t pay the monthly fees. The state also received approval to charge higher cost-sharing for nonemergency use of an emergency room and to make coverage effective when the first payment is made, not when a person applies.

Because Indiana chose an alternative path, it is subject to conditions that come with the waiver it received. Among the conditions is that the program must be evaluated to determine if it’s meeting the expected result.

In a letter to Department of Health and Human Services Secretary Sylvia Burwell, Pence expressed concern about the objectivity of one of the contractors chosen by the Centers for Medicare and Medicaid Services. And the governor argued that because Indiana has contracted an independent evaluator of its own, there’s no need for the federal government to conduct a review.

Burwell’s response, in addition to defending the “rigorous and objective” process for selecting impartial contractors, expresses support for “maximizing the combined value of the state and federal evaluation.”

But it’s what the secretary says in the opening of her letter that seems most relevant in addressing Pence’s concerns. “I am glad that Indiana expanded Medicaid last year,” she wrote, “and that we were able to work together on HIP 2.0 to provide quality, affordable coverage with essential health benefits to low-income people.”

The waiver granted by the federal government to a state headed by a Republican governor who happens to be no fan of Obamacare didn’t come easy. But both sides cooperated and compromised and as a result, hundreds of thousands of low-income Indiana residents now have coverage. Pence should encourage input from the federal officials who worked with his administration to make this possible instead of finding fault with a review that hasn’t even been completed. In the end, the feds’ evaluation could help make HIP 2.0 even better.

This was distributed by Hoosier State Press Association. Send comments to dr-editorial@greenfieldreporter.com.