GOP Medicaid bill would cut enrollees and add work requirement
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More than 200,000 Hoosiers could lose health coverage under a new proposal from Senate Republicans to control ballooning Medicaid costs.
The big picture: Caucus leaders outlined their priority bills on Wednesday, the first day of the 2025 legislative session, focusing on property taxes, water resources and health care costs.
- Senate Bill 2, aimed at containing Medicaid costs, would cap the number of people who could participate in the Healthy Indiana Plan, or HIP, at 500,000 and institute work requirements for participants.
- HIP, a Medicaid expansion program that provides insurance to low-income working-age adults, currently covers more than 700,000 Hoosiers.
- With a cap in place, thousands of eligible Hoosiers would be placed on a waiting list for entrance into the program.
What they're saying: "We can only spend what we have," said Sen. Ryan Mishler, R-Mishawaka, the Senate's top budget writer. "We have wait lists for a lot of programs. And if you want to take away a wait list, then you have to say, 'Do we want to cut education to not have wait lists?' Those are the decisions we're faced with."
- Mishler said those who lose coverage should qualify for a plan on the federal health insurance exchange, so "there shouldn't be anybody that totally loses coverage."
Yes, but: The full text of the bill isn't expected to be made available to the public until next week, so it's unclear exactly how the cap would be implemented, how the work requirements would be enforced or how much money the changes would save the state.
State of play: Medicaid expenses grew by more than $3 billion over the last two years, making it the fastest growing part of the state budget.
- Lawmakers have been ringing the alarm bell about the program's rising costs for several years.
- House Speaker Todd Huston said he hadn't looked at Senate Bill 2 yet but said he felt the pressure to address Medicaid spending.
- "We want to make sure we're providing Medicaid services to those individuals that really need it," he said Wednesday. "And I think our Medicaid roles are disproportionately large, comparable to our state and where we are economically."
The other side: Rep. Greg Porter, D-Indianapolis, said the work requirement would be problematic.
- Instead, he said, House Democrats would like to see a pause on the state's private school voucher program, which cost more than $400 million last year, in favor of covering Medicaid costs.