Indiana Medicaid History and Facts

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Initial Medicaid Implementation: Indiana initially began their Medicaid program in January of 1970. The federal government had essentially set that date as the deadline for states to participate or else existing program funding would end. Indiana was one of several states that did not initially offer a program for the “medically indigent.”

Key Medicaid Political Issues: In 1991 the state consolidated services under the Family and Social Services Administration (FSSA) which contains the state’s SNAP program, disability, elderly, and child services programs in addition to Medicaid. The state has had a limited budget for mental health services that has put a strain on the state’s Medicaid program.

Medicaid Expansion Implementation: Then Indiana governor Mike Pence expanded Medicaid through a waiver in 2015. The program was branded HIP 2.0 named after the originally HIP program. Indiana had a program that covered a limited number of adults at the state’s regular matching rate. The state wanted to continue this program with the enhanced Medicaid expansion federal matching rate. CMS did not agree to this, requiring the state to enact Medicaid expansion to receive the enhanced match rate. The waiver that was eventually agreed to contains several provisions that limit enrollment and the use of medical services by beneficiaries. These include a lock-out period that prevents people from re-enrolling if they fail to pay their premiums, premiums that can be used as a health savings account, and co-payments and other cost sharing. There have been significant disagreements between the state and the federal government about how the state would collect data and evaluate the demonstration. In 2018 the state added work requirements and strengthen the lock out provisions of the program. As of August 2018 these provisions had not yet been implemented but plan to take effect in January of 2019.

General facts about Indiana Medicaid:

Medicaid program name: Medicaid

CHIP Program name: Hoosier Healthwise

Separate or combined CHIP: Combination

Medicaid Enrollment: 1.5 million (2017 estimate)

Total Medicaid Spending: $10.5 billion (FY 2016)

Share of total population covered by Medicaid: 19% (2015)

Share of Children covered by Medicaid: 40% (estimate)

Share of Medicaid that is Children and Adults: 75%

Share of Spending on Elderly and people with disabilities: 72%

Share of Nursing Facility Residents covered by Medicaid: 60% (estimate)

FMAP: 66.7%

Expansion state: Yes

Number of people in expansion: 381,600 (2016)

Work Requirement: Yes

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