Indiana delays return of Medicaid Premiums. Advocates hopeful federal agency will intercede

The state is delaying the return of Medicaid premiums and expects to release its plan to restart POWER accounts in January. Some Indiana Medicaid advocates are still hoping the federal agency in charge of Medicaid will prevent the resumption of premiums before then.

Premiums are required for Healthy Indiana Plan Plus members by state law. But it was temporarily paused during the continuous coverage period where members couldn't be disenrolled due to the COVID-19 public health emergency.

The state is required to bring these premiums back now that the period has ended.

Tracey Hutchings-Goetz, the communications and policy director for Hoosier Action, said advocates appreciate the state is working with the public for the return of premiums, but are concerned about the impact this can have on Medicaid members.

“Right now people are experiencing a lot of confusion about Medicaid,” Hutchings-Goetz. “So this is just another layer to it.”

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In August, advocates wrote a letter to the director of the Center for Medicaid and CHIP Services asking for two Medicaid waivers to be suspended, including the one that gives the state the authority to charge premiums.

Hutching-Goetz said advocates still hope the Centers for Medicare and Medicaid Services will suspend the waiver that allows premiums for Indiana Medicaid.

“There seems to be a growing concern, and I think rightly so, that premiums do not contribute to the mission or the spirit of the federal law which established Medicaid,” Hutching-Goetz said.

In November, CMS determined Wisconsin’s Medicaid premiums “can present a barrier to coverage”, and ended the state’s authority to charge premiums. That decision referenced a report on Indiana’s Medicaid premiums showing premiums contribute to racial health inequities.

It’s not clear whether CMS plans to review Indiana’s Medicaid premiums. The agency declined to comment on a potential decision on Indiana's authority to charge premiums.

Abigail is our health reporter. Contact them at aruhman@wboi.org.