Indiana’s conservative Medicaid experiment—which the Trump administration holds up as a model for the nation—appears to have defied the expectations of both its biggest cheerleaders and harshest critics.
Healthy Indiana Plan 2.0, which Vice President Mike Pence rolled out when he was the state’s governor, requires beneficiaries to pay small amounts toward their monthly premiums. Seema Verma, the new head of the Centers for Medicare & Medicaid Services, helped design the program when she was a consultant and worked with other states on similar Medicaid overhauls, and Department of Health and Human Services Secretary Tom Price has called it a “best practice for other states to follow."
Many on the left have been critical of the program, worried especially about the penalties for nonpayment of premiums, Politico reports. But a state evaluation of the program’s first year noted that since many enrollees are below the poverty line, it’s more common for them to simply be bumped into skimpier coverage plans.
And if you ask health officials in poor, rural Scott County—which was ravaged by an HIV outbreak two years ago—the program has been working relatively well, the article adds.
Dawn Sanders, an outreach worker for Covering Kids & Families of Indiana, which works in Scott County, told the publication that she has seen plenty of “success stories” in which signing up for coverage helped those struggling with substance abuse problems.
And Beth Wrobel, who runs a federally qualified health center in Valparaiso, Indiana, told the publication that diabetes patients who visit her clinic are better able to afford their tests and supplies under the Healthy Indiana Plan.
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However, Sanders indicated that one of the broader Republican goals of the program—promoting more personal responsibility among Medicaid beneficiaries when it comes to health spending—is tougher to execute. Advocates do what they can to educate beneficiaries, she said, “but you can only give them so many pamphlets.”
Nevertheless, Verma and Price have encouraged governors to take advantage of Affordable Care Act waivers and innovate their own conservative Medicaid overhauls. Maine, Arizona and Kentucky, for example, are all aiming to add work requirements into their Medicaid programs, which the Obama administration opposed.