This is a pretty eye-popping stat from Kaiser Health News: Indiana kicked about 25,000 people out of its Healthy Indiana Program — the Medicaid expansion program approved under then-Gov. Mike Pence — for not paying their premiums.

The rationale: The idea of adding premiums to Medicaid is to get enrollees used to the world of private health insurance, where you can also lose your coverage if you don’t pay your premiums. But most private insurance is job-based, where the risk of losing your coverage is lower because your share of your premium automatically comes out of your paycheck.

Worth noting: About half of those people got new health coverage in other ways, usually through a job. But that still leaves a lot of people who just lost their health coverage.

The big picture: Kentucky’s recently approved Medicaid waiver made headlines because it imposed work requirements on Medicaid benefits, but it also added premiums to the program, ranging from $1 to $15 per month. This is a trend.

  • But the Indiana news could jump-start a debate over whether low-income people can afford to pay for their coverage at all.

What’s next: HHS secretary Alex Azar is headed to Indiana today, possibly to announce the approval of its Medicaid work requirements. (HHS wouldn't confirm this.)

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