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HIP 2.0 Eval Shows Enrollees Willingness To Pay, Even As Some Lack Understanding

UW Health

Indiana’s Medicaid expansion, HIP 2.0, has wrapped up its first year. The state estimates about 60 percent of all eligible Hoosiers have enrolled in some form of the plan, which aims to instill personal responsibility in low-income residents with a payment model based on commercial insurance standards.

HIP members can choose to use either a basic plan or the so-called “Plus” plan, which includes dental and vision insurance in exchange for a monthly contribution tied to a person’s income. If the person fails to pay into their health savings account, they’re knocked down to the basic plan, which provides fewer services and requires co-payments.

A state-commissioned independent evaluation by the Virginia-based Lewin Group found the majority of enrollees both below and above the poverty line chose the so-called “HIP Plus” account, which requires all members, no matter what their income, to make some contribution toward a health savings “Power” account in exchange for expanded services.

Indiana Medicaid Director Joe Moser says that means the program’s model is working.

“Even in the lowest income group—those between 0 and 50 percent of the federal poverty level—60 percent of them were making their contributions to be in HIP Plus,” he said during a public hearing on the plan at the Statehouse Tuesday. “[This] demonstrates we think these contributions are affordable.”

He continued, quoting the Lewin report: “It appears the Power account contributions do not constitute a barrier to enrollment in the HIP program.”

However, the study also found not all enrollees completely understand the program. About two-thirds of HIP Plus members and half of Basic HIP Plan members knew what a Power account was.

Susan Jo Thomas of Covering Kids and Families says as later adapters enroll, that level of understanding could decrease.

“As the second wave of late adopters come on, what we do notice is these folks do need a little more hand-holding and more case management,” she says.

The study found the majority of enrollees are concentrated in four of the five most populous Indiana counties.

The Indiana Family and Social Services Administration says enrollment is lagging in the state’s western and southern counties.   

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