Indiana is in urgent need of a HIP (2.0) replacement

INDIANAPOLIS – Indiana House Democratic Floor Leader Linda Lawson of Hammond issued the column below last week:

When Indiana Governor Mike Pence announced his solution to the health care woes facing hundreds of thousands of Hoosiers—expanding the Healthy Indiana Plan to create HIP 2.0—his declaration was greeted with general acclaim, even from many of my Democratic colleagues who had been skeptical of HIP as the means for providing affordable care.

I will not be joining that chorus of “Amen.”

In my mind, our state is making a huge mistake by addressing this problem through a framework that I feel is simply incapable of meeting the health care needs of so many people.

Furthermore, by continuing to stubbornly reject the benefits offered through acceptance of the federal Affordable Care Act, our state is tossing away millions in taxpayer dollars, thousands of new jobs, and denying the kind of comprehensive coverage that truly can make Hoosiers healthy.

My concerns about the Healthy Indiana Plan have nothing to do with its intent, but with the way it was implemented by the last administration and the current one.

Remember that when it was created, Healthy Indiana was supposed to carry a steady state enrollment of around 130,000 individuals. After more than five years of operation, enrollment never got to 50,000. Indeed, the waiting list to get into the program came close to 60,000 people until that list was arbitrarily ended by the Family and Social Services Agency through a rule change.

If a shortfall in funding was considered the reason why the program did not expand, please consider that there is now more than $300 million in the HIP Trust Fund.

In other words, HIP has over-promised and under-delivered. Yet we are asked to believe this program should be the template for an expansion of health care services in our state.

Despite all the happy talk from the governor and his supporters, a few facts remain unchanged:

There is no definitive timeline of when HIP 2.0 will be operational and enrollment can begin. There is a very great chance that it could be another year before it gets the proper approvals and an infrastructure is built to handle recipients.

Already we have seen cracks forming in this perfect plan. Those most in need who have the least financial means will be compelled to enter into a plan that offers no dental or vision care and only a limited pharmacy benefit. In addition, they will be asked to pony up for expensive co-payments for essential health care benefits…a requirement not demanded from those who take part in the second tier of the revised HIP program.

Combine these details with a vaguely-defined “Gateway to Work” requirement and you begin to get the feeling that many of the people who are supposed to benefit from HIP 2.0 might not even apply for it. The burdens might be too great. In other words, the exact reason why we need a new health care system will be the cause for many people choosing not to take advantage of it.

And while we dither, our neighboring states gladly accept the federal dollars that have come by accepting the Medicaid expansion that is a part of the Affordable Care Act. They continue to enroll tens of thousands of individuals to receive expanded health care. Let me put that another way: OUR tax dollars are funding THEIR health care.

There’s more. By denying this expansion, we are depriving Hoosiers of the chance to go for more than 30,000 new jobs that experts believe will be created in Indiana’s health care industry.

The easiest answer, of course, is to follow the path of these other states and sign onto the Affordable Care Act. But acceptance of that plan would be admitting that the President of these United States had the right solution to answer our health care woes. Such admissions are not politically acceptable.

Far better to turn Indiana into a grand laboratory for experimenting with the lives of those who do not have the ability to wield great influence in the halls of our Statehouse. Whatever happens to them won’t hurt the governor one bit. He’ll still claim that he has provided affordable health care in Indiana, and hope no one will take the time to examine the pesky details.

But we have wandered down this path before, and for those of us who remember our previous governor’s disastrous efforts to privatize welfare services, I should think that we have learned better lessons than simply putting on a blindfold and swinging at whatever targets might be within our reach.

Unlike our governor, I have spent a good deal of time talking to people in my district who want affordable health care, but just aren’t sure how they can get it. They read about HIP 2.0, but they don’t understand why it isn’t available now. They wonder when it will be available. They want to know what will be covered under this plan. They want to know what it will cost.

I would love to have the answers, but I just don’t know when I can give them.

I do know this: these folks should not be labeled unfairly and blamed for their lot in life. They should be applauded for simply wanting to take care of themselves and their families.

Why should they be lab rats?