What’s New In Medicaid Today

Sometimes news is so interesting you need a night to ponder on it. Yesterday’s announcement that Indiana reached an agreement with CMS to expand its Medicaid program to the ACA-levels (138% of the Federal Poverty Level) was a big surprise and carries with it some very real, long-term implications.  The Indiana model creates two new Medicaid pools: Health Indiana Plan (HIP) Basic and HIP Plus.  HIP basic will be made only available to individuals making less than the federal poverty level and includes coverage of all essential health benefits, subject to certain co-payments for services.  The big news is HIP plus, a health savings account (HSA) model in which beneficiaries are given a wider range of services (health, vision and dental) and must make monthly premium payments that vary based on income.  Indiana is the first state to receive permission to charge income-variable premiums to Medicaid beneficiaries.  Another first is that CMS has agreed to permit Indiana to kick residents out of the program for six months if they fail to pay their monthly premiums (the 6 month lockout is limited to those making above the poverty level.)  The approval of the Indiana plans is likely to attract a number of other Republican-led states that have so far shied away expanding their Medicaid population.  Now that CMS has made these “concessions available” it is likely they will offer similar terms to other states wishing to expand.


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