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CMS Approves Indiana Medicaid Expansion Proposal

February 2, 2015

The Centers for Medicare & Medicaid Services (CMS) announced its approval of Indiana’s Medicaid expansion plan in a press release issued on January 27.

Indiana will become the 28th state (plus Washington, DC), to implement Medicaid expansion. About 350,000 Indiana residents are expected to qualify. Coverage begins February 1.

The plan includes several features unique to Indiana:

  • Monthly premiums are required for beneficiaries between 100 percent and 138 percent of the Federal Poverty Level with a six-month lock-out period for beneficiaries who fail to make payments.
  • Beneficiaries can choose between a basic Medicaid package with low copays and no monthly premiums or a more robust plan with low monthly premiums and no copays.
  • Use of the emergency room for non-emergency services will result in an additional charge of $8 for the first infraction and $25 for the second.

Governor Mike Pence (R) had originally proposed a mandatory work requirement for Medicaid beneficiaries. CMS rejected this request in the final agreement.

Several other states led by Republican lawmakers are expected to debate Medicaid expansion in the coming months, including Florida, Tennessee, Wyoming, Utah, and Montana, Kaiser Health News reported in a January 28 article.

According to the PHI State Data Center, there are over 66,000 direct-care workers in Indiana. Currently, 37 percent of direct-care workers in the region rely on Medicaid.

— by Stephen Campbell, PHI Policy Research Assistant

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