Pence making the rounds for health care exemption

Pence reiterated Friday his administration has ruled out expanding traditional Medicaid under the Affordable Care Act, as more than two dozen states including Kentucky and Illinois have done. Instead, he wants the federal government to waive Indiana from certain federal laws, so the state can implement an expansion of its low-income health care plan while still tapping into Medicaid funding provided by the Affordable Care Act.

He said disagreements center on “principle and policy,” stressing that the bedrock of his proposed expansion of the Healthy Indiana Plan is personal responsibility. Pence said his administration won’t budge on the requirement of participants to make personal contributions toward their health care coverage or face consequences if they don’t. Participants who earn more would face a lockout from the program if they fail to pay their contributions. Participants below the poverty line who choose not to contribute would default to a plan with lesser coverage.

The waiver Indiana is seeking is a highly negotiated thing, said Robin Rudowitz, an associate director with The Henry J. Kaiser Family Foundation.

“A lot of back and forth goes on,” Rudowitz said.

The federal government has already approved waivers for four states to implement the Medicaid expansion found in the Affordable Care Act but in their own way, and Indiana can look to the experiences Arkansas, Iowa, Michigan and Pennsylvania underwent to have their waivers approved.

The federal government has approved monthly contributions in a few waivers, but mainly for individuals above the poverty level – as Indiana’s plan would require, Rudowitz said. In Iowa, the state can require monthly contributions of individuals below the poverty level, but it can’t be a condition of eligibility.

After speaking to President Barack Obama in Evansville on Friday, Pence told the Courier & Press that they “talked through a number of substantive issues” on the state’s health care proposal.

Pence also will be in Washington D.C. this week where he’ll meet with U.S. Health and Human Services Secretary Sylvia Mathews Burwell on the proposal.

“We talked through a number of issues that have arisen in the course of our discussions, and I appreciated the opportunity to call the matter to his personal attention,” Pence said in a statement released following his Evansville visit Friday.

Time is ticking on the federal government to announce a decision on Indiana’s application. The waiver for the current Healthy Indiana Plan, which serves approximately 50,000 Hoosiers and requires monthly contributions, expires at the end of the year.

Pence said his administration has been frustrated with what they regard as a lack of progress in discussions with the federal government. Hoosiers will soon know if his interactions with federal officials have worked to pick those negotiations back up.