Combined Health Insurance Plans May Still Leave Many Uncovered

Despite a highly-touted state health care program and possible federal changes, thousands of Hoosiers could still be left without health coverage.

There are about 2,000 Hoosiers on the waiting list for the state’s health insurance program, also known as the Healthy Indiana Plan.  There’s still space left in the plan to cover more people — but only those with children.  In the first of a two-part series on health care in Indiana, the story of one Bloomington resident who has been on the waiting list since the beginning of the year.

Scott Fleenor lived most of his life without insurance, but in February, a surprise emergency made him reconsider.

I got deathly ill and was taken to my doctor here in Bloomington,” Fleenor said.  “He had to even come to the van to check me out.  He called the hospital and told them to get me in because I was basically dying.  My appendix had ruptured and I was in complete renal failure, so my kidneys were completely shut down.  And I had pancreatitis.”

Fleenor was in the hospital for 18 days.  When he left, he discovered his bill was $12,000.  He was unemployed and uninsured.  Fleenor applied for the Healthy Indiana Plan, or HIP, hoping for financial help.  After waiting a few months for processing, he was put on a waiting list and told it could be a year before a spot opened up.

Among the 2,000 people on the HIP waiting list, stories similar to Fleenor’s are not uncommon. The federally subsidized plan mandates only 45,000 childless adults can be covered at a time. Seema Verma is a consultant with Indiana’s Family and Social Services Administration.  She said the underlying federal philosophy attaches more value to the lives of caretakers.

“It’s just a philosophical issue.  If you’re giving out public health insurance, the people you’re going to prioritize are going to be women and children and society’s most vulnerable populations,” Verman said.  “It’s kind of crude, but in a way, its attaching values to people’s lives, to say who’s the most vulnerable.  And a childless adult is considered the least vulnerable.”

There is no limit for adults with children or people with serious diseases-at least until the money runs out.  1,200 people are insured under the Enhanced Service Plan — for people with life-threatening illnesses.  34,000 caretakers are also covered.  Even so, about half a million Hoosiers have no form of health insurance.  According to FSSA statistics, the number of uninsured Hoosiers is increasing at a faster pace than the national average.  62% of the uninsured are working-age adults.  But Verma said HIP was never proposed as a replacement for traditional health care.

“This is not intended to be a long term solution,” Verman said.  “So we want the individuals to use the health care program when they’re in a bad situation.  But we hope they transition into a commercial plan.”

Those on the waiting list also have the option of purchasing coverage from Anthem or Medwise at the state’s 20-30% discounted group rate.

But Verma said even the discounted rates are unaffordable for those in the lowest income bracket.  She said expanding the funding for non-caretaker adults is the ideal option for covering more Hoosiers.  But finding enough money to cover that list could prove difficult.

Scott Fleenor was able to pay for his care after learning about Volunteers in Medicine, a group of volunteer medical professionals who work pro bono to serve the uninsured in Monroe County.  VIM helped Fleenor pay off his bill.  Of the $12,000 he owed the hospital, only $200 came out of his pocket.

“It’s irreplaceable.  Had it not been for Bloomington Hospital helping me and Volunteers in Medicine helping me then I cannot fathom where I’d be right now financially because they probably would have wiped me out,” Fleenor said.

Volunteers in Medicine currently serves about 2,000 uninsured Hoosiers in Monroe County and has a handful of other branches in Owen County, Indianapolis and Columbus.  Still, the small organization is limited by geography and resources and can’t help cover many more uninsured Hoosiers.  Still, it’s part of a patchwork solution involving both federal and state agencies.

In Wednesday’s conclusion to this series, State Representative Peggy Welch and State Senator Vi Simpson offer other solutions for uninsured Hoosiers, which may not include support for a health care plan proposed by a fellow Democrat — President Barack Obama.

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