Highlight on Indiana: Health Plans Choices Triple While State Fights Premium Subsidies

Indiana residents will have more than three times as many health plans to choose from when open enrollment begins on the Health Insurance Exchanges in November. According to an article from the Times of Northwest Indiana, the number of available plans will increase this year from 278 to 975 as the number of companies offering plans jumps from four to nine.  Although premiums are expected to increase by 5 percent, the rising rate is considerably lower than the double digit increases that Indiana saw before the enactment of the Patient Protection and Affordable Care Act (P.L. 111-148).

Wait and See

According to a Post-Tribune article, the expansion came after what Indiana Department of Insurance General Counsel Tina Korty described as a sort of trial period, when insurers waited to see how Indiana’ s first year went before they decided to offer policies of their own. Although not all of the 975 plans will be available in every county, the upswing will give consumers more choices.

Federal Exchange

Indiana has relied on the federal health insurance exchange in lieu of developing its own exchange under the ACA. The decision not to develop a state exchange came from the administration of Republican Governor Mike Pence.  According to the Times of Northwest Indiana, the Pence administration has decided that the $40 million startup costs and $40 million of annual expenses to maintain a state exchange  are “not worth it.” Governor Pence’s legal challenges to the premium tax credits that over 100,000 Indiana residents received  last year when they purchased plans on the federally run exchange has caused concern. Democratic state senator Karen Tallian fears that if Pence’s lawsuit is successful, the barriers between Indiana residents and health care will grow larger. The Times of Northwest Indiana quoted Tallian expressing her hope that “the General Assembly can stop this destructive silliness and establish an exchange in Indiana.” If Indiana develops an exchange of its own, the Governor’s legal challenges will be rendered moot.

Medicaid Alternative

Governor Pence’s policies on healthcare reform reach beyond the ACA exchanges. In May, the Indiana governor sought approval to expand the state’s Healthy Indiana Plan (HIP) through the help of ACA funds.  In a letter to HHS, Governor Pence refers to the plan as a “viable alternative to Medicaid expansion.” The consumer driven alternative to Medicaid requires Indiana residents to contribute to the cost of healthcare through monthly premiums. Under the proposed expansion, HIP 2.0, Indiana would replace traditional Medicaid for non-disabled adults aged 19 to 64 by expanding HIP to individuals with incomes below 138 percent of the federal poverty level. According to a Kaiser Family Foundation report, the proposal is open for public comment and is currently awaiting CMS approval.

Choice

Whether Indiana will be a model for Medicaid change or a barrier to the growth of the program is a question that waits in the hands of CMS. Yet, despite the uncertain future face of health care administration in the state, Indiana residents who are on the market for health insurance can at least look forward to a greater array of choices when the federal exchange opens for business this November.