Newspaper article Evansville Courier & Press (2007-Current)

Health Care Plan Should Get Feds' OK

Newspaper article Evansville Courier & Press (2007-Current)

Health Care Plan Should Get Feds' OK

Article excerpt

INDIANAPOLIS - Indiana's proposal to offer health care coverage to hundreds of thousands more Hoosiers should gain federal approval, industry experts say. But Indiana Gov. Mike Pence's administration may have to negotiate at least two parts of its proposal with the federal government.

Features of the plan likely to spur conversations with federal health officials are the up to $25 copayment for use of an emergency room in a nonemergency situation and the six-month lockout period for participants earning above the federal poverty line that fail to pay monthly contributions to a health savings account.

Those issues are relatively minor details, said Joan Alker, executive director of the Georgetown University Center for Children and Families.

"As long as both sides continue to talk, I think they are going to get the 'yes,'" Alker said.

What's important is Pence's proposal already reflects the preference of not charging participants under the federal poverty line monthly premiums, said Judy Solomon, vice president for health policy for the Center on Budget and Policy Priorities.

"In doing that, they've really come within what (Centers for Medicare & Medicaid Services) is willing to approve," Solomon said.

In May, Pence unveiled his proposal to cover 350,000 uninsured adults Hoosiers by tapping into Medicaid dollars made possible by the Affordable Care Act. The proposal expands the Healthy Indiana Plan, which currently serves more than 40,000 participants, by dividing the coverage into two tiers. If approved, the federal government would pay for all the cost associated with new enrollees through 2016, and then the federal share gradually declines to 90 percent by 2020.

The tiered coverage is what experts say makes Indiana's plan unique. The plan charges participants above the federal poverty line a monthly contribution. Participants below the poverty line can choose to pay a monthly contribution for greater coverage but default to a plan with lesser coverage and co-pays if monthly payments aren't made.

In Iowa, the federal government allowed premiums for participants below the federal poverty line, but coverage isn't lost if they aren't paid. …

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