Indiana Gov. Mike Braun has unveiled nine executive orders aimed at reversing chronic disease through healthier eating, exercise and reducing Medicaid spend in a joint press conference Tuesday.
Braun was joined by Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, M.D., at a "Make Indiana Healthy Again" press conference, coining the moniker of the secretary's "Make America Healthy Again" initiative.
One executive order (PDF) is designed to bolster Medicaid program integrity by requiring the state to submit a report on improper payments based on CMS Payment Error Rate Measurement Audit data by October. It also instructs the state to “no longer accept” income, residency or age information without verification before enrollment, unless required by federal law.
Indiana will now be prompted to review eligibility information and conduct redeterminations more frequently, cracking down on which individuals may receive Medicaid benefits. The state is tasked with collecting data from agencies like the HHS, the FBI, the Social Security Administration, the Postal Service, the Department of Housing and Urban Development and state workforce and gaming divisions.
“The office shall carefully collect and periodically review data that may indicate a change in circumstances that would necessitate an eligibility review for Medicaid enrollees,” the order reads.
All told, the order gives the indication the state believes enrollment is too high. Indiana will attempt to pull in data on deceased individuals, lottery and gambling big winners, workforce data, Supplemental Nutrition Assistance Program (SNAP) recipients, incarceration records, change of address information, earnings records and national fleeing felon data.
Oz said the state’s Medicaid budget is the top-line item in Indiana, “as it is in almost every state.”
“If it’s doubling, as it has I am told, in the last four years, then it’s not a sustainable program,” he said. “It’s one that desperately needs to be saved and strengthened.”
The executive order said the Medicaid program is expected to increase by $2 billion over the next two years, while the program saw a $1 billion budget shortfall in 2024.
Republicans in Congress in the midst of a funding debate often spell out their willingness to curtail Medicaid spending and ancillary programs, while also saying the program's coverage will not be cut.
Indiana agreed to enter into “any data sharing agreements necessary” for this executive order. The state will also establish performance standards for qualified hospitals “to make presumptive eligibility determinations.” The order issues new punishments for hospitals that do not meet these standards.
Braun said the order ensures everyone on the program is eligible, pointing to a CMS report from 2021 finding an improper payment rate of 28.8% (PDF) in the state.
Food is a focus
Other executive orders announced by Braun were food-related and focused on prevention.
“Today’s nine executive orders reflect a new approach to health policy in Indiana,” he said.
The actions install stricter SNAP program work and eligibility requirements, remove candy and soft drinks from the food stamps program, evaluate food dyes, study the root causes of diet-related chronic disease and increase access to direct-to-consumer food, among other orders.
RFK Jr. encouraged other states to follow Indiana’s lead and take similar action. Simultaneously, Department of Agriculture Secretary Brooke Rollins was in Arkansas for an announcement on a ban of soft drinks and candy from the state’s food stamp program through a waiver request.
“Alone we can’t do this, but we’re getting tremendous help from the governors, from the grassroots,” said RFK Jr..
In their remarks, Oz and RFK Jr. encouraged state residents to embrace a healthier lifestyle through daily walking, better eating habits and continued education. RFK Jr. added “new autism numbers” will be announced soon, days after he said in a cabinet meeting a report will be released in September.