Indiana Subsidy for Private Insurance ‘Doesn’t Go Very Far’

Indiana on May 29 received CMS approval for a Section 1115 waiver demo that allows residents moving from Medicaid expansion to commercial plans to spend up to $1,000 of funds stored in quasi-HSA accounts on insurance premiums or cost-sharing expenses. State officials describe the plan as a way to help former Medicaid members whose income has grown stay insured. However, experts say that the program, which is related to Indiana’s push for Medicaid work requirements, isn’t likely to improve access to coverage for those eligible.

The program allows former members of the Medicaid expansion program, the Healthy Indiana Plan (HIP), who have joined an employer-backed or individual exchange commercial plan to spend up to $1,000 in Medicaid funds on expenses including premiums, copays, prescription drugs and other cost sharing for the 12 months after their transition from Medicaid.

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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