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FSSA threatens HIP Plus program in filing to challenge federal ruling

By Abigail Ruhman

Posted July 14, 2024

The Family and Social Services Administration said without a stay or a reissuing of HIP approval, the agency will have to transition HIP Plus members to different packages that don’t include that better coverage. (Lauren Chapman)

The Indiana Family and Social Services Administration said unless a recent federal ruling is halted, the agency will have to transition HIP Plus members to different packages that don’t include better coverage.

It filed a motion to prevent a federal ruling from vacating the 2020 approval of the Healthy Indiana Plan or HIP. The agency said the ruling creates “considerable uncertainty” for the entire program.

The lawsuit challenged several policies that threaten Medicaid coverage and access. This included POWER account contributions, which were monthly payments required to access HIP Plus – the version of HIP with better coverage.

Advocates said the court’s ruling to vacate approval of the program will prevent people from losing coverage in the future, which furthers the objectives of the Medicaid Act.

FSSA reiterated its claim that the ruling conflicts with state law, which requires POWER account contributions. State officials have made changes that conflict with state law before. Indiana removed the six month lockout period for people who lost coverage because they failed to pay their POWER account contributions.

This meant if a member was disenrolled, they would not be allowed to reapply for the next six months. It was a policy required by state law, but is no longer a part of the program.

FSSA said addressing concerns about how the ruling conflicts with state law and making “substantial systems and operational changes” will take the state a year or longer.

The agency also sent a letter to the federal government asking for support in the motion and to “reissue the HIP approval” if the motion is not granted.

POWER account contributions and other forms of cost-sharing were paused during the COVID-19 public health emergency. The state planned to bring cost-sharing back in July. Advocates raised concerns that the requirement would lead to people losing coverage or being disenrolled, but now FSSA said they will remain paused for the foreseeable future.

Other Medicaid programs are not affected by the ruling. Cost-sharing, including copayments and premiums, for the Children’s Health Insurance Program, or CHIP, and MEDWorks will resume as planned.

Abigail is our health reporter. Contact them at aruhman@wboi.org.