Porter: Gov. Holcomb should halt Medicaid redeterminations until we know why so many Hoosiers are losing their coverage
Over two million Hoosiers – nearly a third of Indiana’s population – benefit from the state’s second-largest program after K-12 education. That program is Medicaid and includes Hoosiers enrolled in Indiana’s Healthy Indiana Plan, Hoosier Healthwise, CHIP or Hoosier Care Connect.
Before COVID-19 and the subsequently declared public health crisis, people enrolled in Medicaid were required to annually renew their coverage and show their state that they were still eligible for coverage. To cover people throughout the pandemic, the federal government paused this process so that as many Americans as possible could have health care coverage. However, because the federal public health emergency has officially been ended, those annual renewals began resuming earlier this year.
Hoosiers should be concerned by how this process has been going so far in our state. In April, 53,000 Hoosiers lost coverage, and in May, 53,600 Hoosiers lost coverage. In May, 82% of those who lost coverage did so for procedural reasons, like incomplete or missing forms. Only 6% of people lost coverage in May because they were no longer eligible. An estimated 600,000 Hoosiers could lose their coverage throughout the entire renewal period – over a third of people enrolled in coverage.
This is unconscionable and unacceptable. Certainly it is everyone’s responsibility to stay on top of their healthcare coverage and deadlines – but I have a hard time believing that over 100,000 Hoosiers (so far) who would otherwise qualify for coverage would knowingly forfeit that coverage.
I am echoing similar calls from Florida’s congressional delegation in order to call upon Gov. Eric Holcomb to pause procedural disenrollments immediately. Similar to Indiana, 82% of Floridians who lost coverage in the first month did so because of procedural reasons. Surely the risk of nearly 10% of Indiana’s population losing healthcare coverage is worth taking a stand. We need to understand why so many eligible people are losing their coverage, whether that’s an information gap, missed opportunities for state intervention or solvable hurdles. Also, this isn’t just adults – it’s also children losing coverage, and it’s not like they can do paperwork themselves. We need to protect the least of us.
What’s more is that beyond appearing unconcerned about this many Hoosier adults and children losing their healthcare coverage, Statehouse Republican leadership has been stoking doubt in the long-term fiscal viability of Indiana’s Medicaid information without presenting the full picture. While the state appropriation for Medicaid has been increasing annually and we should be aware of this, it’s misleading to suggest that the program’s costs are becoming unsustainable.
Consistently for several years now, Indiana’s Medicaid program has not spent its full appropriation and that funding has been diverted to other non-Medicaid expenditures, like the Department of Correction’s Hepatitis C and general medical services costs or the state’s general fund. This money is sitting in different pots all over the place, like the state surplus or a Family and Social Services Administration savings account. In fact, just this month, the State Budget Agency took it even a step further by transferring $713 million of the Medicaid appropriation to the state’s general fund to build up the surplus even further instead of using it for the intended purpose of adequately funding the state’s share of Indiana's Medicaid program.
The full picture here is that state Republican officials have seemed unconcerned by this massive disenrollment of Hoosiers from health insurance, and they have also been skimming off the top of Indiana’s Medicaid appropriation for years while bemoaning its growth. The first step toward rectifying this is pausing the disenrollment of Hoosiers until FSSA can figure out why so many people are losing their coverage for no good reason – and that is an action that Gov. Holcomb should be able to muster the political will to take. Beyond being entirely feasible, this action has also been recommended by the federal government to ensure no one needlessly and inappropriately loses their health coverage.