The state government and health care advocates have praised the federal approval of a waiver to extend state Medicaid through the Healthy Indiana Plan, now called HIP 2.0.

But after reviewing the plan, those who worked to push the process to bring health care to low-income Hoosiers have two lingering questions: What took so long, and why?

“On many different levels, I think this is a wonderful thing. It doesn’t change the fact we could’ve had this all 13 months ago,” said Rob Stone, director of Hoosiers for a Commonsense Health Plan. “I remain skeptical that this plan is any improvement on traditional Medicaid.”

HIP 2.0, which opened for enrollment Tuesday, is estimated to offer health care coverage to 350,000 currently uninsured citizens starting Feb. 1.

For months, Gov. Mike Pence’s administration and the U.S. Centers for Medicare and Medicaid Services negotiated a Medicaid expansion to be paid for by the federal government until 2017, when that funding will decrease to 90 percent of costs. The state estimates it will pay $1.5 billion from 2015 to 2020 without imposing new taxes. HIP 2.0 will be paid for through new hospital assessment fees and Indiana’s cigarette tax.

In order to receive government approval and funding, the state had to make adjustments to HIP 2.0, as well as discontinue several aspects of the original Heaalthy Indiana Plan. HIP 2.0 includes the same essential health benefits guaranteed under the Affordable Care Act, such as preventive care and hospitalization.

Unlike HIP, HIP 2.0 does not have capped enrollment. Any proposal with capped enrollment would not have been approved by the Centers for Medicare and Medicaid Services, nor receive matching federal funds, according to the U.S. Department of Health and Human Services.

Stone participated in a conference call with representatives from the Centers for Medicare and Medicaid Services on Tuesday after Pence announced that the HIP 2.0 waiver had been approved by the federal government.

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