As most Indiana residents and people around the nation now know, Republican candidate for President of the United States Donald Trump recently chose the state’s governor, Mike Pence, to serve as his Vice Presidential running mate in this fall’s election contest. While the pick provided little by way of surprise for those who understood that Trump was likely to choose a mainstream Republican governor as a balance to his own lack of political credentials, it did raise some questions about how certain state policies would proceed now that Pence has abandoned his quest for gubernatorial reelection to pursue the nation’s second-highest elected office. One of those questions involves the potential fate of the Medicaid expansion Pence helped bring to Indiana’s residents.
Healthy Indiana Plan 2.0
That expansion went into effect in 2015, and involves Pence’s own version of healthcare support. Known as Healthy Indiana Plan 2.0 (HIP 2.0), the plan offers a conservative alternative to the way in which many other states have attempted to implement the Medicaid expansion made possible by the 2010 passage of the federal Affordable Care Act. The expanded Medicaid program offered both familiar benefits and new innovations that other Republican governors have since examined and adopted as policy objectives in their own states.
For example, healthy Indiana 2.0 is not just a benefit-distribution program of the kind seen in many other states. Instead, it encompasses a wide range of conservative health care policy suggestions that had been advocated at both state and federal levels for more than two decades. The program includes a conservative favorite – health savings accounts, as well as cost-sharing through premium contributions, an incentivized effort to promote healthy choices and behaviors, and a denial of benefits for anyone who has the means to pay premiums but fails to do so.
The program provides benefits for Hoosiers who are considered low-income, and can be accessed by individuals aged 19-64. In compliance with federal mandates, HIP 2.0 offers a comprehensive range of health care benefits that include everything from doctor and hospital care to diagnostics, mental health care, and prescription medicines. Moreover, coverage is somewhat flexible as residents can choose from different plans. There is even a plan that covers dental care.
An Uncertain Future?
With Governor Pence now out of Indiana’s gubernatorial race, some have wondered whether HIP 2.0 might face calls for an overhaul by the candidates who seek to replace him. That could place the health care status of many Indiana residents in immediate jeopardy, and deny them some of the control they have been able to obtain through the Pence expansion. As a result of these concerns, there has been understandable interest in where the remaining candidates for the Governor’s office stand on this important issue.
Republican Support a Given?
While many might assume that Pence’s Republicans would automatically support the initiative, nothing can be taken for granted. On the surface, however, it would appear as though there is enough support to assume that HIP 2.0 is likely to continue largely unchanged if one of the current Republican contenders for the office wins the race to replace Governor Pence. Three major Republican options have made moves toward joining the race, including U.S Representatives Todd Rokita and Susan Brooks. Pence’s lieutenant governor, Eric Holcomb, has also indicated that he will toss his hat into the ring. Whoever the Republicans pick to represent them in the coming election will face off against Democratic candidate John Gregg in the November election.
Two of those candidates, Rokita and Brooks, have been supportive of HIP 2.0 since it was approved by Health and Human Services in 2015. Lieutenant Governor Holcomb, meanwhile, has not issued direct support for the plan in its existing form. However, some outside observers assume that he is probably supportive of most of its provisions since he served alongside Pence while the plan was being developed.
Democrats in Doubt
The Democrat candidate might be another story, however. Gregg’s fellow Democrats in other states have been hostile to these types of programs in the past, preferring state options that simply focus on distributing as many benefits as possible to as many people, without the options for individual control of things like health care savings accounts. To date, Gregg has yet to expressly declare his intent one way or the other.
Getting Through the Legislature
In the end, though, the candidates’ positions on the matter may not matter as much as the makeup of the state’s legislature when the election is over. If the program is to be changed, those changes will need to be done through the normal legislative process – and that may not be as simple as some might imagine. As long as the Affordable Care Act remains in place at the federal level, some version of this current state plan is likely to be left in place.
All of that could change, however, if the Republican nominee is elected in November. Trump has repeatedly said that he will replace the ACA, and enact a state-controlled block grant program in its place. That could result in major changes to the existing plan, since the Affordable Care Act’s revenue provisions would be gutted along with the rest of the law. For his part, however, Pence has indicated that he doesn’t see this as a problem, since he assumes that states will simply craft new plans similar to his HIP 2.0 program.
In other words, some form of Medicaid expansion similar to this program is probably going to be here after the election, regardless of who wins. That’s good news for younger and middle-aged residents who have already come to rely on these important benefits.
What About Your Care?
Of course, Medicaid isn’t just for people aged 19-64. Many vulnerable seniors need the program’s benefits as well – to pay for long-term care like nursing homes. To be eligible, however, they need to ensure that they qualify for benefits well in advance of the day they apply for help. That requires the type of Medicaid planning that you can only find at firms like Frank & Kraft Attorneys at Law. We can help you to take care of all of your estate planning needs, including vital strategies that ensure that Medicaid is there for you when you need it most. If you’d like to know more about how Medicaid planning can help you to get the benefits you need, contact us online or give us a call at (317) 684-1100.
Mr. Kraft assists clients primarily in the areas of estate planning and administration, Medicaid planning, federal and state taxation, real estate and corporate law, bringing the added perspective of an accounting background to his work.
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