Indiana’s plan to seek a 10-year extension for the Healthy Indiana Plan is good news for the hundreds of thousands of low-income Hoosiers who joined the ranks of the insured thanks to the program.
The bad news? At the same time, the state, led by Attorney General Curtis Hill, is backing a lawsuit that could eliminate all funding for that program.
So goes the confounding reality in Indiana, a state facing a mountain of health challenges: In the most recent America’s Health Rankings, it ranks 41st in overall health, with some of its lowest rankings including obesity (39th place) and smoking (44th).
HIP, an alternative to the Medicaid expansion provided for by the Affordable Care Act, has helped the state make inroads in reducing the number of uninsured Hoosiers since it was approved by the federal government in 2015. In the first year of Medicaid expansion, the number of uninsured declined 19%; in the second year of expansion, the number of uninsured dropped another 16%.
Last month, the Indiana Family and Social Services Administration posted notice of its intent to request a 10-year extension of the federal Medicaid waiver that established the current HIP program, which would expire on Dec. 31, 2020. Its request includes a proposal to extend the expanded substance abuse and serious mental illness components of HIP through 2025.
But all of that could be for naught, depending on the decision by the 5th Circuit Court of Appeals. That decision could eliminate nearly all federal funding for HIP if it strikes down the Affordable Care Act in its entirety. That’s what a coalition of attorneys general of about 20 states — including Indiana’s Hill — is asking the court to do. Any decision by the court will likely be appealed to the Supreme Court.
All of the attorneys general who signed onto the challenge are Republican. Nine, including Indiana, represent states that took the federal money made available by the ACA to expand Medicaid eligibility.
Hill has said that regardless of any good it does, the ACA is federal government overreach.
Last year, a health care coalition of eight advocacy groups called on the attorney general to withdraw Indiana from the lawsuit. A spokeswoman for the group said the ACA has “helped millions of Hoosiers access care and live healthier lives.”
That’s now at risk — and 600,000-plus Hoosiers have reason to fear they’ll lose their insurance. All because of a politically motivated exercise that goes against the interests of millions of Americans — and offers no alternative for those who stand to lose their health coverage. Hill never should have aligned Indiana with this reckless lawsuit.
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