Indiana officials say the CMS is planning to use a biased survey to evaluate the state's conservative approach to Medicaid expansion.
In April, the federal Office of Management and Budget approved an emergency request by the CMS to let it examine whether Indiana's conservative-friendly, alternative Medicaid expansion model known as Healthy Indiana Plan 2.0, or HIP 2.0, has hurt beneficiaries' access to care.
The OMB's quick approval of the three beneficiary surveys proposed by the CMS is critical, because other Republican-led states including Arizona, Kentucky and Ohio are looking to implement versions of Indiana's plan, said Judith Solomon, vice president for health policy at the left-leaning Center on Budget and Policy Priorities. She said that data on Indiana's expansion will offer insights about whether there are any drawbacks for patients. Comments on the surveys were due June 3.
Indiana Gov. Mike Pence, a Republican, has argued there is no need for the CMS to perform its own evaluation of his plan because the state already hired the Lewin Group, an independent consultancy, to do so.
The Pence administration has raised several concerns about the surveys, including use of questions it says are biased and that include response options that are leading. For instance, enrollees are asked to consider their overall experience and then asked about the specific reasons for being dissatisfied. However, there is no question asking about being satisfied.
“The lack of balance points to dissatisfaction and is leading,” said Tyler Ann McGuffee, insurance and health policy director for Pence, said in a comment letter to the CMS.