- Capped enrollment;
- Premium payments as a condition of eligibility for people with incomes below the federal poverty level; and
- Premium payments in excess of 2 percent of income.
Tuesday, January 27, 2015
Family Voices shares the following from CMS (Centers for Medicaid and Medicare Services):
Fast Facts on Healthy Indiana Plan:
Beneficiaries will begin to have access to quality, affordable coverage with the essential benefits guaranteed by law beginning on for eligible individuals.
Indiana’s plan establishes POWER Accounts, which beneficiaries will use to pay for some of beneficiaries’ health care expenses. These accounts will be funded, in part, through beneficiary contributions.
Beneficiaries will have access to all of the essential health benefits that are required under the law. The agreement allows two benefit packages (HIP Plus and HIP Basic), each covering all essential health benefits required by law and available to people based on their premium (POWER Account) contributions.
Individuals who are charged premiums (in the form of POWER account contributions) will enroll in HIP Plus and have no other cost sharing, expect for certain emergency room services. These individuals will also have the opportunity to reduce their premiums through incentives like receiving preventive care or through a rollover of their POWER account. For people with incomes at or under 100% of the federal poverty line (FPL) who elect to pay cost-sharing rather than premiums, cost sharing will comply with regular program limits and total cost sharing will not exceed 5 percent of the family income.
CMS did not approve a work requirement as part of this agreement. Indiana will seek to encourage employment through a state-funded incentive program that will be administered separate from the Medicaid program. Participation in this program will not impact coverage or costs for individuals. While states may promote employment through state programs operated outside of the demonstration, this is not permitted under the Medicaid program.
Co-payments for certain emergency room services to some individuals will be allowed in connection with a study testing whether copays encourage care in the most appropriate settings while not harming beneficiary health. Federal law allows waivers on cost sharing payments only based on meeting several criteria including the presence of a control group so that the impact can be carefully studied. Individuals who seek treatment at the emergency room will be charged copays ($8 for the first visit, $25 for the second visit). Those assigned to a “control” group will not be charged.
Individuals with incomes at or below 100% FPL are not subject to a lockout of essential benefits. A person who is not medically frail and has income above the poverty line who stops paying premiums can be locked out of coverage for six months – reduced from 12 months in the current Indiana plan – and subject to certain exceptions.The new demonstration shortens the lock out period from 12 months under HIP 1.0 to six months, limits the lock out to only people with incomes above 100% FPL who are not medically frail, and adds additional exceptions for some individuals. For instance, individuals with incomes at or below 100% FPL will also be given a 60-day grace period after non-payment of premiums before being automatically enrolled in HIP Basic.
Several features of HIP 1.0 were not continued as part of this new demonstration. These policies would not be authorized as part of a Medicaid expansion demonstration that, under the Affordable Care Act, triggers the enhanced federal matching funds. This agreement does not permit:
Family Voices Indiana shares the following press release regarding HIP:
INDIANAPOLIS—Governor Mike Pence announced today that the State has received approval from the federal government to use an updated version of the consumer-driven Healthy Indiana Plan known as HIP 2.0 instead of Medicaid to offer access to quality health care to 350,000 uninsured Hoosiers. The Family and Social Services Administration (FSSA) will begin taking applications immediately, and coverage will begin February 1.
“Since the beginning of my administration, we have worked hard to ensure that low-income Hoosiers have access to a health care plan that empowers them to take charge of their health and prepares them to move to private insurance as they improve their lives,” said Governor Pence. “This has been a long process, but real reform takes work.”
HIP 2.0 participants are required to contribute to a POWER account, which they manage like a health savings account and are rewarded for using preventive care. Consequences for non-payment range from mandatory co-pays for services to loss of coverage. In addition, the plan includes a co-pay for emergency room use, designed to encourage appropriate use of the emergency room.
The plan also offers low-income Hoosiers an option to receive assistance in purchasing private-market insurance through their employers, called HIP Link. The use of a health savings account as part of a premium assistance program is the first of its kind in the nation. The plan also refers applicants to job training and job search programs offered by the State of Indiana.
With this approval, Indiana will end traditional Medicaid for all non-disabled Hoosiers between 19 and 64 and will continue to offer the first-ever consumer-driven health care plan for a low-income population. In addition, the State will reform its traditional Medicaid program by increasing reimbursement for healthcare providers, which will improve access to care. The State negotiated the rate increase as part of its agreement with the Indiana Hospitals Association, which will help fund the Healthy Indiana Plan so it can be offered at no additional cost to taxpayers.
“The expanded and updated HIP 2.0 is based on a program that has been serving 60,000 low-income Hoosiers in our state for seven years,” said Governor Pence. “It is a proven model for Medicaid reform across the nation.”
For information on how to enroll in the Healthy Indiana Plan, visitwww.HIP.IN.gov or call 1-877-GET-HIP-9.
Monday, January 26, 2015
A group of Families, Trainees, and Professionals will be spending Tuesday January 27th on Capitol Hill Meeting with members of Indiana’s Congressional Delegation. We will be speaking about:
· The importance of the Maternal and Child Health Block Grants to Indiana’s Families
· The role of the Family to Family Health Information Centers to assist families who are raising children who have special health care needs
· The role CHIP plays in providing access to coverage and care for children in Indiana
Plan to call, email, Facebook and Tweet members of the Congressional Delegation in support.
Ask others to speak up, too.
It makes an impact when member are hearing from multiple Hoosiers around these issues.
Tuesday, January 20, 2015
I’m a policy analyst at the Kaiser Commission on Medicaid and the Uninsured at the Kaiser Family Foundation. I am reaching out to you because we are embarking on a video project called “Faces of Medicaid” that seeks to put a face to some of the 68 million Medicaid beneficiaries in the United States. This project forms part of our commemoration of the program’s 50th anniversary this year. As such, we are seeking Medicaid beneficiaries to participate each in a short (60-90 second) video that describes the important role that Medicaid plays in their lives.
Examples of past projects (although without video) include Faces of Medicaid (http://kff.org/interactive/
faces-of-medicaid/) and Faces of Medicaid Expansion (http://kff.org/health-reform/ report/faces-of-the-medicaid- expansion-how-obtaining- medicaid-coverage-impacts-low- income-adults/ ). We believe that telling these stories in a video format which can be promoted through social media and available on YouTube as well our own website (KFF.org) will expand the reach of this project while also providing a more powerful medium within which to tell these stories.
We are specifically seeking folks with the following types of stories:
Beneficiaries in ACA expansion states:
1. A newly eligible working adult with Medicaid coverage
2. A parent and child who both have Medicaid coverage – parent may be newly eligible
3. A person with a mental health diagnosis or other chronic condition with Medicaid coverage
Beneficiaries in non-ACA expansion states:
4. A working childless adult who is in the Medicaid coverage gap/without coverage
5. A parent who is uninsured/in the Medicaid coverage gap with a child who has Medicaid coverage
6. A person with a mental health diagnosis or other chronic condition without coverage/in the Medicaid coverage gap
Benefciiaries with disabilities – in any state:
7. A child with a significant disability (Katie Beckett) – (would feature parent and child)
8. A senior using long-term care services – (would feature senior and adult child who helps with care/accessing services)
9. A person with a disability using Medicaid to support his/her ability to work
Providers in ACA expansion AND non-expansion States
Hospital CEOs/Administrators and Physicians who can discuss the impact of Medicaid or lack of Medicaid expansion on their work, their patients, their bottom line, etc.
We are hoping to begin filming by the beginning of February so we are in a bit of a hurry to identify and speak with people.
Thank you and please let me know if you have any questions.
Melissa Majerol | Policy Analyst and Special Assistant to the Executive Vice President
KAISER FAMILY FOUNDATION | WASHINGTON, DC
If interested, please contact Melissa at the contact info above.
Friday, January 16, 2015
The American Association on Health and Disability (AAHD) is pleased to announce the publication of two new fact sheets for the National Disability Navigator Resource Collaborative (NDNRC). “What to Know When Assisting a Consumer who has a Child or Youth with Special Health Care Needs (CYSCHN)” is intended to help Navigators identify what issues are unique to children and youth with special health care needs so that they can assist their families as they make decisions related to their healthcare coverage. This fact sheet can be found here. Special thanks to Family Voices for their authorship of this fact sheet. This fact sheet is the latest in a series of new fact sheets that the NDNRC is releasing which provide navigators and other enrollment specialists with information they need to help these specific populations within the disability community. Previous population specific fact sheets which we released are as follows:
- What to Know When Assisting Children and Adults in the Autism Community
- What to Know When Assisting a Consumer with Intellectual Disability
- What to Know When Assisting a Consumer with Mental Illness
- What to Know When Assisting a Consumer with Multiple Sclerosis
- Information for Veterans Regarding Department of Veterans Affairs Healthcare
We are also excited to announce the release of our latest topical fact sheet. “Tips for ACA Enrollees: From Coverage to Care - Persons with Disabilities” is intended to be a document that navigators can provide to people with disabilities to assist them in using their new insurance coverage consistent with the CMS "Coverage to Care" initiative. This fact sheet can be found here. This fact sheet adds to the series of topical fact sheets released in year one which have addressed issues such as a health plans’ summary of benefits and coverage, rehabilitation and habilitation therapies and devices, and prescription medication benefits. The entire list of fact sheets (along with upcoming fact sheets) is also available here.
Feel free to contact Family Voices Indiana for more information: 317 944 8982 email@example.com
Thursday, January 15, 2015
Since the start of Open Enrollment, millions of Americans have taken action to make sure they’re covered for 2015. But there’s still more work to do to ensure that more families are able to find and sign up for quality, affordable health insurance through the Marketplace.
We need your help to continue to get the word out. Here’s what you need to know:
Wednesday, January 14, 2015
Indiana Coalition for Human Services (ICHS) has partnered with Indiana Association of United Ways to host webinars for the 2015 legislative session. These webinars will go over current legislation and what is happening at the statehouse. They also provide a platform for members to have their questions answered.
Register for the January 22 webinar that will be recorded live at 3:00 pm ET.