Policy Update, May 30, 2014

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Understanding the HIP 2.0 proposal

Governor Pence released the details of his proposal for "HIP 2.0," a request to the federal government to use the Healthy Indiana Plan as the framework for healthcare coverage expansion in Indiana. HIP 2.0 would create a three-tiered structure to cover Hoosiers who are 19-64, without disability and with incomes between 24% and 138% of poverty. Currently, 350,000 uninsured Hoosiers fall in the "coverage gap" with no options for health insurance, as they have incomes too high for Medicaid and too low for Marketplace plans. Read the proposal or the FAQs.

Overly summarized, the proposal would:

replace traditional Medicaid for non-disabled adults ages 19-64;
create a HIP Basic plan for non-disabled adults whose incomes are below 100% poverty that would provide minimal basic medical coverage;
create a HIP Plus plan for non-disabled adults whose incomes are between 23% and 138% of poverty that would provide medical, dental and vision coverage (where consumers contribute to a POWER account, or health savings account, for access to a better plan than HIP Basic); and
create a HIP Benefit Link plan where the State may support employer-sponsored coverage for low-wage workers.

The HIP 2.0 proposal preserves many features popular with consumers and providers, including access to preventative care, sliding scale contributions and reimbursement rates for providers that are higher than for traditional Medicaid. Advocates are hopeful that the HIP model will help "bend the cost curve" by incentivizing consumers for smart use of health services (i.e., avoiding non-emergency use of emergency rooms, accessing preventative care).

The State has developed the plan and is collecting public comments (see below) for submission to the federal Center for Medicare and Medicaid Services (CMS). If the federal government does not approve the proposal for HIP 2.0, the State is requesting continuation of the current HIP program for the 47,000 Hoosiers currently enrolled in HIP.

The administration is planning several community sessions around the state. Sessions have already been held in Indianapolis, South Bend and Gary. Upcoming sessions include:

Bedford - June 3, 12:30 pm ET, McReynolds Conference Room at IU Health Bedford Hospital, 2900 West 16th Street
Jasper - June 16, Noon ET, Memorial Lodge, 2590 S. Newton Street

Additional dates and locations will be posted.

Comments on plan for HIP 2.0 are due June 21

The IN Family and Social Services Administration is accepting comments on its proposal for HIP 2.0. Two public hearings were held in Indianapolis this week. Most individual who offered verbal comments praised the plan and the administration, urging CMS to expedite plan approval. A few offered questions for clarification about certain features of the plan or about planned implementation strategy. Advocates have expressed a desire that state and federal planners consider a strong public education and outreach strategy to help consumers understand their options and responsibilities under HIP 2.0. Examples of concerns raised include: consideration of specific types of coverage (i.e. mental health); how the lockout period would work; ways for consumers in a "cash only" economy to be able to make monthly payments regularly; and more.

Human service providers and consumers with direct experience with being uninsured, on Medicaid and on HIP are encouraged to submit comments to IN FSSA before June 21.

How do I submit comments? Ideally, comments succinctly express support, opposition or concerns about the proposed plan. Comments may include specific information, data or recommendations. Identify yourself, your organization and population served. Do not include any confidential information, as comments become a part of the public record. Learn more about the public comment period.

Does your government contract pay the full cost of services?

If not, you are not alone, says new report.

Nonprofits continue to be challenged by contracting processes with local, state and federal governments, according to recent report by the Urban Institute and the National Council of Nonprofits, Toward Common Sense Contracting: What Taxpayers Deserve.

Problems examined included governments...

not paying nonprofits the full costs of providing the services
utilizing wasteful contracting application processes
changing contract terms mid-stream
routinely failing to pay on a timely basis
imposing complex and time-consuming reporting requirements

The Urban Institute offers state profiles as a part of its complete 2013 report. See how Indiana ranks in government contracting. The full report offers recommendations about how to improve processes.

Legislative Study Topics announced

The Legislative Council announced the interim study topics earlier this month.

Agriculture and Natural Resources will study 1) statewide policy for recreational trails and 2) shooting preserves and related issues.
Corrections and Criminal Code will study a number of issues, including issues related to individuals with autism spectrum disorders and juvenile alternatives initiatives and issues.
Courts and Judiciary will consider 1) data privacy issues and 2) whether a father who abandoned a birth mother during pregnancy should be required to consent to adoption of a child.
Education will study 1) pre-kindergarten and early learning and 2) school discipline issues.
Employment and Labor will study work-sharing unemployment benefits.
Fiscal Policy will consider 1) health insurance exchange and ACA issues, 2) multi-year review of tax incentives, 3) comparison of tax credits for historic preservation, 4) local property tax burden.
Pension Management Oversight will review local government pension plans and public pension program.
Public Health will consider a number of issues, including INSPECT, opioid treatment programs, chronic eye disease and more.
Commission on Improving the Status of Children will consider under-reporting of crimes against children.

See the full list of Interim Study Committee Topics as announced May 14. This is the first interim with the consolidation of committees and topics per SEA80.

IN211 report shows connections to SNAP benefits

Indiana 211 Partnership has partnered with the State of Indiana to provide outreach to Hoosiers who might be eligible for SNAP benefits. The US Dept. of Agriculture estimates that approximately 300,000 Hoosiers are eligible for Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, but are not receiving them. Many of the eligible are working in low-wage jobs, seniors or people with disabilities. See May report or other reports.

Uninsured and after the open enrollment period:

Life events may qualify someone for a special enrollment period

While the official open enrollment period ended in March, certain individuals may qualify for a special enrollment period. Getting married, having a baby or starting a new job are qualifying life events. Additionally, young people who turn 26 need to obtain their own insurance once they are no longer eligible for coverage on their parents' insurance.

The Dept. of Health and Human Services reminds consumers of healthcare options before the next open enrollment period starts in November. Navigators are available to help. Call 2-1-1.

By popular clicks...Community Report Cards

The Community Report Card is a tool to see a quick snapshot of how your community is doing on key indicators in education, income and health. Check out your community.

IaUW Public Policy

IaUW is a nonpartisan organization that works to advance policy principles and compromise solutions for the common good. We focus on programs and policies that help:

children prepare for and succeed in school;
individuals achieve and sustain financial stability;
individuals access quality healthcare; and
communities thrive, including a strong 2-1-1 network and charitable sector.

Our policy priorities are developed and guided by our Public Policy Committee and our IaUW members, based on their work in Hoosier communities.

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