Indiana Medicaid Changes Could Leave Gary Residents Without Coverage
New state legislation in Indiana could significantly change how Medicaid and the Healthy Indiana Plan (HIP) are managed. Signed by Gov. Mike Braun last week and set to go into effect on July 1, these changes are expected to affect low-income residents, including those in Gary, by tightening eligibility verification, imposing new financial requirements, and limiting outreach.
In Gary, where just over 40% of residents are insured by Medicaid, these policy changes are likely to have far-reaching effects. Residents may face more frequent eligibility checks, reduced flexibility in meeting program requirements, and fewer opportunities to learn about or apply for health coverage. Community advocates have raised concerns that the combined effect of these provisions could increase the number of uninsured individuals in vulnerable populations.
Below is a breakdown of the key provisions and their potential impacts.
The Indiana Office of the Secretary of Family and Social Services Administration is now required to implement a wide-ranging system of eligibility verification for Medicaid recipients. The goal is to ensure that only individuals who meet income and residency requirements remain enrolled. Key provisions include:
Elimination of self-attestation: Applicants will no longer be able to self-report income, residency, household size, or other qualifying details without third-party verification prior to enrollment.
Monthly data matching with the Indiana Lottery Commission and Gaming Commission to flag recipients with winnings of $3,000 or more. Those found ineligible will have coverage terminated.
Quarterly and annual reviews of employment, wages, and tax data from the Department of Workforce Development and Department of State Revenue.
Monthly checks against records from the Supplemental Nutrition Assistance Program (SNAP), the Department of Correction, and vital statistics to verify residency, incarceration status, and deaths.
Ongoing checks using federal databases covering earnings, benefits, incarceration, and other changes in household circumstances.
Any information indicating a change in eligibility status triggers a required redetermination. The state may also contract with third-party vendors for additional database searches.
How it affects Gary residents: Though the intended purpose claimed for these measures is to improve program integrity, they could lead to coverage disruptions, especially among individuals whose economic or living conditions change frequently.
Several amendments to HIP will create stricter requirements around work participation and cost-sharing:
Work requirements are now more narrowly defined. Eligible adults must meet specified conditions such as employment, participation in job training or volunteer programs, enrollment in substance use treatment, or caring for a dependent. Full-time students and recently incarcerated individuals may also qualify for exemptions.
Cost-sharing rules have been reinforced. Coverage does not begin until an initial contribution is made to a Personal Wellness and Responsibility (POWER) account. Participants must continue making annual payments — either 2% of household income or a minimum set by the state.
Penalties for nonpayment:
Individuals at or below 100% of the federal poverty level face reduced benefits, such as the loss of vision and dental coverage, and new co-pay requirements.
Those above the poverty line are subject to disenrollment and a six-month lockout if they miss payments by 60 days or more.
The law explicitly bars the state from reducing these penalties or waiving the cost-sharing requirements.
How it affects Gary residents: These provisions could pose significant financial challenges for low-income households, potentially resulting in reduced access to care or loss of coverage due to missed payments.
State agencies and their contractors are now barred from advertising or broadly marketing Medicaid programs. While providers may still advertise their own services, general promotion of the Medicaid program is prohibited under the new rules.
How it affects Gary residents: Reduced outreach and public awareness campaigns could make it harder for eligible residents to learn about available programs or navigate the application process, particularly in communities with limited access to digital information or legal aid.
The post Indiana Medicaid Changes Could Leave Gary Residents Without Coverage appeared first on Capital B Gary.
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