Health Care Reform

Getting Hip with HIP 2.0

Ryan Miller
May 11, 2017


Hoosiers, you’re HIP. Not only are you HIP, but you’re also in a position of incredible political influence with regards to the future of health care in the United States.

Through seven years of “Obamacare” and 100+ days of the Trump administration, the Affordable Care Act (ACA) remains the law of the land. And the political battleground is still anything but silent. Even though the new American Health Care Act has taken its first steps through the House, it still has a long way to go and will most likely still be subject to some level of revision. For all that was included (and excluded) from the proposed bill, I’ll offer up this excellent evaluation from my colleague Katy Stowers.

While we wait for AHCA: Step Two, let’s take a moment to appreciate the known rarity that is the Healthy Indiana Plan 2.0 (HIP 2.0), its uniqueness, and how it affects Hoosiers and Hoosier employers.

How did HIP become so hip?

The Affordable Care Act asked states to expand Medicaid to 138% of the Federal Poverty Level (FPL). While there were states that did just that, another collection of states simply said, “No way.” Then another handful said, “Okay, but we want to do it our own way.” Here in Indiana “our way” was the expansion of the Healthy Indiana Plan (HIP) into HIP 2.0 through the approval of a Section 115 waiver. Only five other states have successfully applied for Section 115 waivers to expand Medicaid to “bridge the gap” without simply expanding Medicaid.

So we’re one of six. Why does that matter compared to all the others? Any GOP “repeal and replace” response to the ACA is going to have significant impact upon the State-based and Federally-facilitated Public Exchanges and the subsidies that go along with their participants. This means that Medicaid spending will be a key component of any new legislation. In the hands of the GOP, this has traditionally resulted in returning the decision-making power to the states, and as luck would have it, Seema Verma (current Administrator of CMS) and continued by then-Governor Mike Pence (current Vice President) was the Healthy Indiana Plan architect.

If you’re looking for a framework drafted by participants in the current administration and approved by regulators in the prior administration, look no further than the Hoosier state! That may be the closest thing to “bipartisan support” that you can find in the current political arena.

HIP helping employers

And by the way, HIP 2.0 doesn’t just impact low-income Hoosiers; it also can be leveraged by employers sponsoring health plans. By becoming a HIP Link Employer, eligible employees can utilize the resources available through HIP 2.0 (maximum health plan contribution of 2% of earnings, eligibility for a state provided Personal Wealth & Responsibility account) to make their own coverage more affordable and provide them with state-provided funds to keep their family healthy. While the 138% FPL metric may not trigger many eligible employees at your company, it’s typically the families that could see great benefit from this program (think “front line employee” with a non-working spouse and two children).

The conversations surrounding health care have only just begun. Take a little time to learn about the trails we’ve blazed here in Indiana, and don’t be surprised when HIP 2.0 jumps off the billboards in our great state and right into the 24-hour television news cycle.