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HIP Proposal Aims to Meet Medicaid Rules, Cover More Hoosiers

The Indiana Family and Social Services Administration has devised a proposal for insuring some of the 23,000 childless Hoosiers who are eligible for coverage through the Healthy Indiana Plan but are currently on a waiting list.

The proposal would change the way HIP pays for prescription drugs, allowing it to meet budget-neutral stipulations required by Medicaid. Once the state’s program meets those requirements, it can insure more Hoosiers.

Medicaid currently pays seventy-four percent of medical bills incurred under HIP.  A large portion of the program is also paid for with state cigarette tax dollars. HIP provides health care through the private health insurers MedWise and Anthem, which includes the cost of pharmaceuticals for those covered.

The private plans make HIP ineligible for rebates enjoyed by Medicaid under contracts with pharmaceuticals. The new proposal would shift the responsibility of prescriptions to Medicaid, allowing HIP to get the same drug discounts.

FSSA Consultant Seema Verma says this would create savings for both Indiana and the federal government. She says the savings the state could then use the money to insure the 23,000 childless Hoosiers currently on waiting list.  Verma says the rebates would save thirty to forty percent of drug costs and provide a presentable case for covering more non-caretaker adults.

We’re going to save you so much money, on these pharmacy rebates, so can we use those savings to cover more childless adults? Because the Medicaid program is paid for, also by the federal government, when we save money, the Federal government saves money as well,” she said.

Verma says the state’s health care initiatives make strides in covering uninsured Hoosiers, but she says the FSSA is also waiting on the outcome of pending federal health care legislation before making significant changes in the state.

“There are efforts there to cover childless adults. There are efforts there to expand Medicaid eligibility.  But I think at this point, it’s important to see what the federal government’s going to do.  And waiting to see what that looks like before we start changing things,” she said.

There is no timeline on if, or when, the FSSA’s proposal will receive consideration. Verma says they are simply waiting to hear back from the state.

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