Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HIMSS 2023
  • Opinion
    • Breaking Bias
    • Commentaries
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • 40 Under 40
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - AI and Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
July 25, 2016 12:00 AM

Success of Pence's Medicaid expansion far from settled

Virgil Dickson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Pence

    The success of the conservative approach to Medicaid devised by Indiana Gov. Mike Pence—Donald Trump's pick for vice president—is a mixed bag so far, according to a report that offers fodder for both sides of the political spectrum.

    A new analysis funded by the state shows both positive and concerning elements to Indiana's alternative Medicaid expansion. It again exposes the dichotomy of Pence embracing President Barack Obama's healthcare reform law even though his presidential running mate, Donald Trump, has called for full repeal of the Affordable Care Act.

    The report also comes as Indiana state officials continue to raise objections to the CMS performing its own analysis to see if Pence's Medicaid expansion has been harmful to beneficiaries. Pence has argued there is no need for the agency to perform its own evaluation because the state already commissioned a report by the Lewin Group, an independent consultancy.

    Pence's version of Medicaid expansion took effect last year. His Healthy Indiana Plan 2.0—which includes premium contributions, health savings accounts, incentives for healthy behaviors and a benefit lockout for people who don't pay premiums—has become a model for conservative Republican governors in other states such as Kentucky and Ohio.

    More than 90% of HIP 2.0 beneficiaries have been able to continue to make contributions into an HSA as a condition of coverage, according to the report. Payments range from $3 to $25 a month depending on income level.

    But almost half of Medicaid enrollees sometimes, usually or always worried about being able to make those HSA contributions.

    People living below the federal poverty level who don't pay into the HSA will still have basic Medicaid coverage, but will lose dental and vision benefits, according to Indiana's waiver. People living above the poverty level who miss HSA payments are locked out of coverage for six months.

    As of January 2016, there were 345,656 HIP 2.0 enrollees. Over the first year of the demonstration, 2,677 individuals above the poverty line were disenrolled from HIP and not allowed to return for six months for failing to pay their contribution, according to the report.

    The state revealed 21,445 Medicaid members transitioned to the basic offering due to nonpayment of the contribution.

    Affordability was not the leading reason for not making the contributions. Instead, most cited confusion over the fact that they needed to make a payment, or when the payment needed to be made. Indiana's HSAs are called Power accounts.

    “It appears that Power account contributions do not constitute a barrier to enrollment in the HIP program,” the Lewin report says. But almost 1 out of 5 Medicaid enrollees were “always” worried about making their contributions, indicating there's still a level of financial hardship for the state's poorest residents.

    Seventy-four percent of HIP 2.0 beneficiaries said they were able to get routine care as soon as they needed it and nearly 80% had no trouble getting access to specialists. Overall, 58% of members reported that they were very satisfied with the new Medicaid program, while an additional 22% said they were somewhat satisfied.

    Consumer advocates and policy experts were skeptical of some of the findings. “If the results are as good as Pence and others are saying it is, they should welcome having another reviewer taking a look,” Dee Mahan, Medicaid program director at Families USA, said of CMS's attempts to evaluate HIP 2.0.

    Observers note an independent federal evaluation is important if other conservative states decide to copy Indiana's expansion as a model.

    “The stakes are pretty high since other Republican states are interested in similar designs, and CMS wants to understand how these reforms are affecting beneficiaries before greenlighting it for other states,” said Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation.

    Republican insiders were mixed on what the report may mean for Pence and Trump's bid for the White House. On one hand, it shows the ticket achieved some sort of right-leaning legislative success.

    “The program demonstrates the governor's character—compassion, desire to solve problems and guidance by conservative principles,” Joey Fox, an Indiana-based GOP strategist and former legislative director for the Indiana Department of Health under Pence, said in an email. “Americans will be impressed with those qualities.”

    But Pence's embrace of the Affordable Care Act, a law that is anathema to Trump and congressional Republicans, draws unfavorable attention to the Republican bid for the White House.

    “Increased attention to Pence's expansion of Medicaid may harm his conservative credentials,” said Yevgeniy Feyman, a fellow at the Manhattan Institute, a conservative think tank.

    “I don't think it matters," countered Douglas Holtz-Eakin, an adviser to Sen. John McCain's presidential campaign in 2008 and former director of the Congressional Budget Office. “He is the vice president pick, not the nominee, and it's the nominee's policies that matter.”

    He said that because Trump opposes the Affordable Care Act and is in favor of Medicaid block grants, the success of HIP 2.0 would be moot should Trump become president.

    “I don't think there will be pressure to produce the Indiana model anywhere else,” Holtz-Eakin said.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    congress prescription drugs
    PBMs, Big Pharma face off in House hearing
    Biden COVID copy_i_i.jpg
    Biden administration asks employers to help more workers who lose Medicaid
    Most Popular
    1
    Centene to lay off 2,000 workers
    2
    How health systems are battling price-gouging allegations
    3
    Senate advances bill to temporarily aid hospitals, health centers
    4
    Elevance, Blue Cross Louisiana halt $2.5B proposed deal
    5
    Tower Health to sell urgent care centers, close others
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HIMSS 2023
    • Opinion
      • Breaking Bias
      • Commentaries
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • 40 Under 40
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing