Comments on Indiana’s HIP 2.0 1115 Waiver Application for submission to the Centers for Medicare and Medicaid Services
by Rylin Rodgers:
Family Voices Indiana serves Indiana families who are raising children who have disabilities and special health care needs. As our state’s federally funded Family to Family Health Information Center we help families navigate the complex world of Health Care Financing. Today I am here to speak about how the Healthy Indiana Plan 2.0 (HIP) impacts the families we serve. Thankfully, the overwhelming majority of children we serve have pathways to coverage. But in truth that is not enough; what happens to their parents matters. Several studies have concluded that parental coverage improves the continuity of coverage and access to care for children, and reduces the likelihood of breaks in children’s coverage. We have found this to be true for the families we serve. We have also found through lived experience how critical preventative health care is for parents of children who have special health care needs. The stresses of care giving raise the importance of access to care for this population of parents. For many of the families we serve, HIP 2.0 may provide health insurance where no other option was available.
As we have followed the discussions about HIP as a vehicle to accept the federal dollars available to cover low income Hoosiers, we have done so with worry about the families we serve and how the complex realities of caring for their children will fit with this plan.
· Families raising children who have disabilities and special health care needs often have significant burdens on their budgets that make the premium requirements unmanageable. A parent whose child requires a nutritional supplement that costs over $200 a month is not able to reallocate those funds to pay their own premiums.
o For this reason we applaud the ability to stay on HIP Basic even when premiums are missed for those under 100% of the FPL.
o We urge that the lock-out provision be removed for those over 100% of the FPL, or at a minimum a system is created to consider the impact of caregiving costs on a participants’ ability to pay.
· Parents of children who have disabilities and special health care needs are all too aware of the overwhelming reality of unexpected medical costs and are skeptical about coverage that contains yearly and lifetimes caps. As a result, they may not access coverage that is limited.
· Of greatest concern are the details about providing seamless coverage transitions between the Health Insurance Exchange and HIP for parents whose income changes. This is critical for the families we serve as they need a way to maintain coverage when their child’s medical needs require a change in their work status.
In short, Family Voices Indiana supports the transformation of HIP into a plan that increases access to care for Hoosier Families. We urge continued focus on issues of income change and hardship and on efforts to ensure seamless continual coverage as circumstances change.