03/12/2009 - Health insurance plan faces dilemma (Louisville Courier-Journal)

Health insurance plan faces dilemma
Childless adults are put on waiting list

By Lesley Stedman Weidenbener
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INDIANAPOLIS -- The state's health-insurance plan for low-income adults, barely over a year old, already has run out of slots for anyone who doesn't have kids.

Childless adults seeking coverage will now be put on a waiting list, the Family and Social Services Administration announced yesterday.

However, the program still has room for low-income parents and for caretaker relatives living with dependent children.

The distinction between categories of adults is made by the Centers for Medicare and Medicaid Services, which waived federal rules to allow Indiana to start its program but still included the restriction.

"This limit could not come at a worse time for Hoosiers, when we know so many are hurting," Family and Social Services Administration Secretary Anne Murphy said in a statement. "It is regrettable that we do not have the ability to enroll more clients who are in need of health coverage."

In all, the program -- financed by federal Medicaid dollars, state cigarette taxes and participant contributions -- has enrolled about 49,000 Hoosiers, including 34,000 childless adults. That's the limit federal officials put on that category.

Indiana House Health Chairman Charlie Brown, D-Gary, said yesterday the limits "don't make sense" and he will talk with agency officials about how the state might be able to expand the number of slots available to childless adults.

"I'm concerned the waiting list could mushroom," said Brown, an author of the legislation two years ago that increased the state cigarette tax to help fund the program. "We underestimated the number of childless adults who would be eligible and applying and we may need to make some changes."

The program is open to those adults whose income is no more than 200 percent of the federal poverty level -- about $42,600 for a family of four -- and who have no access to employer-sponsored insurance. Participants pay a monthly premium that ranges from about $20 to $75.

Higher-income Hoosiers can buy into the program by paying the full cost.

Typically, the federal government does not provide Medicaid funding for insurance programs for childless adults, but lawmakers in 2007 thought including them in the Healthy Indiana Plan was important. So Family and Social Services spent months negotiating a waiver.

But agency spokeswoman Lauren Auld said the waiver was only possible because the Indiana Hospital Association and lawmakers struck a deal to divert federal funding for hospitals to the program

"In order to cover more childless adults, we would have to open our waiver again and find a new revenue source to fund the additional coverage," she said.

For now, any adult without children who applies for coverage will be issued a denial letter and included on the waiting list based on the date and time the application was received. If someone else drops out of the program or obtains employer-sponsored health care, slots will open.

Agency officials said yesterday the waiting list will be monitored daily. Auld said officials will talk with lawmakers about how the state might expand the program.

Brown said he'll urge the agency to ask the federal government to reconsider, particularly in light of Democrat Barack Obama's election as president.

"The folks there seem interested in health care," Brown said. "They might be willing to lift those restrictions."