By MICHELE F. MIHALJEVICH

Indiana Correspondent

INDIANAPOLIS, Ind. — The extension of Indiana’s health insurance program for low-income residents includes a work requirement along with funding for substance addiction treatment.

The Healthy Indiana Plan (HIP) offers health insurance to non-disabled Hoosiers ages 19-64 who don’t have access to help in paying for it. More than 400,000 Indiana residents are enrolled in the program.

The extension announced Feb. 2 is through December 2020. HIP was scheduled to expire Jan. 31, 2018, but was given a one-month extension on Jan. 29.

Alex Azar, new secretary of the U.S. Department of Health and Human Services (HHS), joined Indiana Gov. Eric Holcomb and Jennifer Walthall, secretary of Indiana’s Family and Social Services Administration, for the extension announcement.

“Indiana’s vision and ours goes beyond the provision of quality health care,” Azar noted. “It recognizes that Medicaid can become a pathway out of poverty, paving the way for better, long-term health for all enrollees.

“We can only make this vision a reality in cooperation with states like Indiana. Healthy, fulfilling lives require not just health coverage and health care, but also a sense of purpose often obtained through work.”

HHS recently approved a community engagement model in Kentucky, he said. The agency has had requests from 11 other states to discuss models similar to Kentucky’s and Indiana’s.

The initial version of HIP was launched by former Gov. Mitch Daniels in 2008. An expansion – HIP 2.0 – was announced by then-Gov. Mike Pence in 2014. HIP currently has a voluntary Gateway to Work provision that offers HIP enrollees help with job training and job searches.

Beginning in January 2019, HIP members will be required to work, attend school, volunteer or participate in other qualifying activities up to 20 hours a week. The program includes several exemptions, including for those medically frail, pregnant or in treatment for substance use.

Indiana has almost 90,000 unfilled jobs, Holcomb said. About 130,000 people enrolled in HIP don’t work.

“Filling those jobs is going to take an ‘all hands on deck’ approach,” he explained. “This Gateway to Work initiative is going to help connect eligible HIP members to the very training they need to take that next step up, so that our state collectively can fill that pipeline and we can take the state to the next level as well.”

HIP will offer funding up to $80 million annually over the life of the extension to help with treatment and resources for those with a substance addiction, including to opioids, Holcomb said. The funding is for anyone receiving Medicaid and not just for HIP members.

It’s difficult to know what impact the changes to HIP might have on the number of people eligible for it, said Leonardo Cuello, director of health policy for the National Health Law Program (NHeLP). The organization is helping to represent several Kentuckians who filed suit in January against changes to that state’s Medicaid law.

“After the approval in Kentucky of a similar provision, I can’t say it was a surprise (changes to HIP were approved by HHS),” he stated. “I’m disappointed they would approve, for a second time, a bad policy. Why would you take two steps back?

“There are half a dozen ways to terminate you from (HIP). Primarily, the goal is to reduce the size of the program. Secondarily, the dogmatic goal is trying to punish people who are low-income.”

NHeLP is considering legal action in Indiana, Cuello said. “There is a considerable amount of harm that will be done to the people in Indiana. We think the law is clearly on our side. Their actions are so contrary to the letter of the law.”

Walthall said the state will clearly communicate the program to Hoosier residents.

“We want HIP to continue to be what it’s already been for so many – the pathway to what comes next in life,” she noted. “We’re building this with an intentional goal of having zero people have their benefits suspended.”