Indiana residents have enjoyed a reduction in the number of people lacking health insurance coverage, thanks to provisions of the Affordable Act and the state’s decision to expand its Medicaid program in 2015. Thus far, federal estimates indicate that the number of uninsured residents has fallen roughly 30%, and stood at 9.6% at the end of 2015. That’s a noteworthy accomplishment, though many correctly note that the state still lags behind the nation in this effort.
A Late Start
Indiana boosters are quick to remind critics that the state did get off to a slower start than many other states. The ACA passed in 2010, and there was a rush by many states to take advantage of the Medicaid expansion program to ensure that their residents got the health insurance they needed. In Indiana, however, the state created its own plan for expansion, incorporating more of a market-based approach, with people participating in the plan being required to contribute to their own health care accounts.
That program had to await federal approval, of course, and that wasn’t obtained until well after many neighboring states had already implemented the federal expansion. Once Indian’s plan was approved, however, the reduction in the number of uninsured residents was dramatic. Moreover, some experts are predicting that the state will see continuing declines in the number of uninsured in the coming years, as the benefits of its plan continue to be realized.
Where Does It Go from Here? Problems Linger
Some are fearful that all of this may unravel, though, since the state is currently dealing with a federal evaluation of Indiana’s program. That evaluation was a necessary prerequisite for federal approval of the Hoosier plan, since the state needed to obtain approval for waivers of a number of Medicaid rules. If the federal government decides to set aside those waivers, the state could be forced to return to the drawing board to rethink its options.
The two sides have had difficulties with the evaluation process, as Indiana balked at the federal government’s demands for data sharing. According to state officials, the federal authorities failed to reassure the state that the data provided would be secure. Since that data includes sensitive personal health details, the state’s health officials feared that the exchange of information could place those residents’ health records and privacy interests at risk.
To complicate matters even more, the Governor, Mike Pence, alleged that the Obama administration had intentionally hired a contractor that was biased against the Indiana plan. Pence also argued that the federal government had no real need to evaluate the Healthy Indiana Plan, since the state had already retained analysts to review the program and its results.
The Critics’ Voices
It is important to note that a number of high profile critics have expressed doubts about the Healthy Indiana Plan. These include organizations like the March of Dimes, Families USA, and the American Cancer Society Cancer Action Network. These groups and others have taken aim at certain provisions of the Indiana plan, and accused it of possibly posing a threat to the program beneficiaries. Many of those advocacy groups are resisting the Indiana plan out of fear that other states might follow its lead should the program prove beneficial to the state’s residents.
What the Feds Want
Federal officials have been quite clear about one thing, however: they say that they will judge the effectiveness of any proposed plan based on its likelihood of either improving or harming any given state’s existing coverage plans. That could make it difficult for states like Kentucky and others to gain approval to adopt certain aspects of Indiana’s plan – since all the government needs to do is claim that the adoption would set back progress in other states.
Still, the Obama administration is in a tough spot when it comes to evaluating progress. According to the Census Bureau, gains like those seen in Indiana are in keeping with what the government intended when it passed the ACA in 2010. If that is indeed the case – and most objective analysts would probably agree that it is – then it would be difficult to imagine how the federal government could now complain about the Healthy Indiana Plan if it is accomplishing the ACA’s declared goals.
What Does It Mean for You?
If you’re one of those residents who still remains uninsured, it is important to find out what you need to do to correct that deficiency. Health care costs continue to rise, and there is little indication that Medicaid expansion will be able to prevent that increase. To protect yourself from those high costs, you need health care insurance to help cover your care costs.
If you’re a senior in need of long-term care, however, the HIP won’t be of much help to you. Instead, you need to qualify for Medicaid in other ways. That can sometimes be difficult when you’ve spent a lifetime gathering assets and now find yourself with just enough wealth to prevent you from qualifying for program benefits, but nowhere close to what you need to self-finance your nursing home care. How should you respond to that challenge? An elder law attorney can certainly help you make sense of your options.
At Frank & Kraft, Attorneys at Law, we understand how confusing all of the recent changes in health care legislation and coverage options can be. Medicaid expansion has undoubtedly left many seniors and others wondering how they need to proceed with this brave new health insurance world that has become their reality. Out elder law experts can provide you with the asset protection and planning guidance you need to ensure that you make sense of all of these changes in a way that secures your interests for the long-term. If you’d like to learn more about what Medicaid expansion has done for the state of Indiana, or discover how we can help you with your elder law and estate planning needs, give us a call at (317) 684-1100, or contact us at our website today.
Paul A. Kraft, Estate Planning Attorney
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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