Indiana Senate gives Medicaid bill final approval
Indiana Gov. Mike Braun will receive the Senate Medicaid bill in the coming days as the Senate gave final approval to the bill Thursday.
The Senate voted 37-10, with all Republicans present voting in favor of the bill and all Democrats voting against it, Thursday on the Medicaid bill to affirm the amendments made by the House.
Senate Bill 2 — authored by Sen. Ryan Mishler, R-Mishawaka — places restrictions on Medicaid, including work requirements, with 11 exemptions, on an insurance program for Hoosiers with a medium income and between ages 19 to 64.
The bill requires the office to establish performance standards for hospitals that create eligibility requirements and action for when hospitals do not comply with standards.
The House Public Health Committee amended the bill to remove a 500,000 cap on the Medicaid program. The House Ways and Means Committee amended the bill further to allow an Indiana resident enrolled in or attending an accredited educational program full-time to be eligible for the plan.
The House Ways and Means Committee also amended the bill further to allow the secretary of Indiana's Family and Social Services office to advertise or market participation in the Medicaid program. The office can also reimburse medical providers at the appropriate Medicaid fee schedule rate for some medical claims prior to the beginning of benefits.
When the state first established the Healthy Indiana Plan, the Indiana Medicaid program, in 2006, there were 40,000 people on the program, Mishler said. Before COVID-19, there were around 390,000 people on HIP, and currently there are more than 700,000 people on the program, Mishler said.
Overall, Medicaid has grown by $5 billion in the last 4 years, Mishler said, and the rate of growth is greater than the state's revenue increase. In the upcoming 2-year budget the legislature is working on, Mishler said the majority of new revenue will cover Medicaid costs.
Sen. Shelli Yoder, D-Bloomington, said while she's pleased the program cap was removed from the bill, her 'continued concerns' were the increases in administrative costs as the bill calls for more eligibility checks and the work requirements.
The Kaiser Family Foundation found that 73.1% of people on Medicaid in Indiana have jobs, and the remaining 26.9% are either caregivers, in school, too medically frail to work, or have trouble finding a job, Yoder said.
Ultimately, Yoder said the bill makes Indiana's Medicaid program 'more complicated' which will result in people who qualify for coverage getting kicked off the program. Then, when they need healthcare, those individuals who were kicked off the program will go to emergency rooms for care, which increases the state's healthcare costs, she said.
'While the language has changed, the goals haven't wavered,' Yoder said. 'We don't want to punish people for being sick.'
Sen. Mike Bohacek, R-Michiana Shores, said he supported Senate Bill 2 because it will ensure 'that those folks that are on the program are eligible.'
'When the pandemic happened, we expanded Medicaid and we let a whole lot of folks on it. A lot of those folks, many of them, weren't qualified and weren't eligible but we did it anyway because it was the right thing to do because we had a health emergency. Those times are over, and now it's time to get back to where we were before,' Bohacek said.
Sen. Fady Qaddoura, D-Indianapolis, said the bill kills Medicaid expansion in Indiana because it will give state control over the program and limits elements of the Affordable Care Act.
While the bill was amended to remove the cap, Qaddoura said the program is still capped because it states that FSSA 'shall limit enrollment in the plan to the number of individuals that ensures that financial participation does not exceed the level of state appropriations or other funding for the plan.'
'The solution is not to reduce eligibility. The solution is not to reduce appropriations. The solution is not to withdraw from the Medicaid expansion, but rather the solution is to look at the population and find alternative policies,' Qaddoura said.
Sen. Chris Garten, R-Charlestown, said Medicaid is 23% of the state's budget. He said Indiana's Medicaid program 'exploded because of COVID,' when non-eligible people joined the program.
'Every dollar that goes to somebody that's not eligible is taking away a dollar from a poor, disabled Hoosier who otherwise should be getting that dollar and receiving benefits,' Garten said.
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