INDIANAPOLIS — In an effort to address the ballooning costs of Medicaid, which have increased by $5 billion over the past four years, lawmakers at the Indiana Statehouse are prioritizing Senate Bill 2.
Authored by State Sen. Ryan Mishler, the legislation aims to implement work requirements for participants in the Healthy Indiana Plan and mandates quarterly eligibility checks for all two million Medicaid recipients.
The bill has garnered significant attention, with numerous individuals signing up to testify before the House Public Health Committee. The bill passed out of the Senate earlier in the session.
“You are going to see most of our new revenue in this budget is going to Medicaid, and that’s going to take away from other programs and services," Mishler said during the committee. "So I just feel we have to get Medicaid under control. It’s not the cure; it’s just one piece of a bigger puzzle that we have to work on with Medicaid.”
Tracey Hutchings-Goetz from Hoosier Action expressed concerns regarding the quarterly eligibility checks, stating, “The majority of Healthy Indiana Plan members, for instance, 78 percent work, and those members of HIP who are not working likely live in a household with workers, are full-time caregivers to children, are too sick to work, or cannot find employment.”
The implementation of quarterly check-ins particularly impacts self-employed individuals. Susan Brackney is self-employed and a participant in HIP 2.0.
“It’s different for someone who is self-employed," Brackney said. "My income fluctuates a lot from month to month. So if you just look at it quarterly maybe I had a really good quarter but by the end of the year it sort of all washes out, and I’m still where I am.”
Providers have also expressed apprehension about the potential impact on patient care.
Dr. Alison Case from Indy HealthNet testified against the bill. Her clinic provides care to people in Medicaid and those who don't have health coverage.
She says it could lead to delayed care, and potentially a closure of clinics if reimbursements aren't issued. She says the process of receiving government-funded care is complicated and often the websites and red tape required to do so have significant issues.
"A bill that makes enrolling for Medicaid more difficult for patients will lead to people losing their Medicaid, getting sicker, and ultimately seeking care at ERs, which are already overwhelmed," Case said.
In response to the concerns surrounding the bill, an amendment was made to remove the cap on the number of Hoosiers eligible for the Healthy Indiana Plan. Previously set at 500,000, this cap was eliminated during committee discussions.
The legislation also addresses issues surrounding media advertising for Medicaid programs.
Some lawmakers believe such advertisements take funds away from needed care and would be better used for patient programs, while nonprofits and advocacy organizations worry that new restrictions may hinder their ability to inform the disabled and sick about available resources.
Although work requirements are a key element of the bill, there are exemptions for various groups there are currently 11, and the following could be added:
- Individuals volunteering
- Those receiving unemployment benefits
- Participants in substance abuse programs
Additionally, the Family and Social Services Administration (FSSA) will be required to issue a report on improper payments and fund recovery linked to high-net-worth individuals who transfer assets before accessing Medicaid for end-of-life care or nursing home stays.
It’s important to note that the work requirement applies only to the Healthy Indiana Plan, which primarily serves able-bodied childless adults, and does not affect all Medicaid recipients.
The bill passed out of the Public Health Committee and now heads to the full house for further consideration. It still has a long way to go before it heads to the governor's desk.
