INDIANAPOLIS
(AP) — Senate Health Chairwoman Pat Miller said Friday that Indiana's
health savings account program should be used to meet the requirements of
the new federal Medicaid expansion.
Miller,
R-Indianapolis, is drafting a proposal that would expand coverage using
the Healthy Indiana Plan and ask the federal government to cover the cost
using block grants. It also would set guidelines for "navigators" required
under the federal law to help residents use the insurance exchange once
federal officials have set it up in Indiana.
The Healthy
Indiana Plan "contains a lot of the things I think are important for
consumers, including wellness and personal responsibility for their health
as well as some financial responsibility, which would be a co-pay or some
kind of premium based on income," Miller said.
She plans to
discuss the measure in her committee next Wednesday, as lawmakers decide
how to handle the federal health care law. Gov. Mike Pence has all but
shut the door on running a "hybrid" insurance exchange with the federal
government, and he said earlier this week the only way he would sign off
on a Medicaid expansion would be if it met same the terms laid out by
Miller in her new amendment.
Throughout the
debate, the growing cost of Medicaid has towered over the number of
uninsured residents in Indiana as a breakpoint for any expansion.
Milliman Inc.,
the actuary hired by former Gov. Mitch Daniels to assess the law's impact
on the state has floated a series of eye-popping cost estimates over the
last few years. The firm estimates that a full expansion, for all
residents earning up to 133 percent of the federal poverty line, would
cost $2.6 billion over the next seven years.
Broken down,
that number seems somewhat less daunting. A full expansion would cost
$94.5 million more next year and grow to $524.8 million a year by 2020.
The U.S.
Supreme Court allowed Medicaid expansion last year in its ruling upholding
the constitutionality of the federal health care law. Under the law,
states can increase the eligibility under their Medicaid programs to
people whose incomes equal 133 percent of the federal poverty level.
The federal
health care law gives states the option to accept the expansion, refuse it
or postpone a decision. But there are benefits for states that choose to
expand Medicaid now: The U.S. government will pick up the entire cost in
the first three years and 90 percent over the long haul. Three years of
full federal funding for newly eligible enrollees — roughly $2 billion a
year — is available from 2014 through 2016, gradually phasing down to 90
percent in 2020 and after.
Vastly
outnumbered Indiana legislative Democrats are continuing the push to
accept traditional Medicaid coverage, arguing that the Milliman analysis
ignores significant cost savings as fewer uninsured residents use the
emergency room for primary care, leaving insured residents to eat the
cost.
House Minority
Leader Scott Pelath, D-Michigan City, and Senate Minority Leader Tim
Lanane, D-Anderson, also argued that Indiana should join Republican
leaders in other states like Michigan, Ohio and Arizona who are approving
the Medicaid expansion.
"They've
already said that they are going to expand Medicaid as a way by which to
implement the health care act," Lanane said. "So I believe Indiana is sort
of the island in the middle, and I don't think we want to be known as the
island of the uninsured."