Politico featured a worrisome story Monday raising concerns about Obamacare’s demise wreaking havoc on disadvantaged HIV patients in Vice President Mike Pence’s home state of Indiana, but it looks like they left out a few important details.
Indiana’s conservative version of Medicaid expansion has made it a target for some on the political left, but the state’s patient advocates are up in arms about Washington repealing Obamacare and the Healthy Indiana Plan (HIP) 2.0, according to Politico. In a piece titled “How Mike Pence used Obamacare to halt Indiana’s HIV outbreak,” the publication makes the case for HIP 2.0 and highlights fears about the potential demise of the program.
“We are currently in a panic about what’s going to happen,” Jaymes Young of The Damien Center, an AIDS services organization in Indiana, told Politico. “Hopefully the ACA stays … it was complicated and imperfect but now we’re used to it.”
“It’s been a miracle for Indiana,” said Susan Jo Thomas, executive director of Covering Kids and Families of Indiana, a nonprofit that helps sign Hoosiers up for HIP 2.0 coverage. “I don’t want to talk or think about the consequences of losing it. It’s terrifying.”
Under HIP 2.0, 400,000 low-income Hoosiers got medical coverage, including a significant number of people who are addicted to opioids and who are HIV-positive. The program was especially helpful to these groups, Politico reports, because it offers substance abuse and mental health treatment. It also helps get patients to doctor appointments and therapy sessions. The article suggests that losing the program would be detrimental to Indiana’s efforts to combat an opioid crisis that hit the state particularly hard.
Politico (and other publications) have reliably billed HIP 2.0 as part of Obamacare. The plan is a far cry from the standard Medicaid expansion included in the health care law, which may be why Indiana faced significant opposition from the Obama administration on several key requirements during negotiations over a federal waiver for the program.
HIP 2.0 features a monthly premium for everyone — as low as $1 for many participants — which is set aside in a health savings account that the patients themselves control. If, after a grace period similar to that in Obamacare exchanges, participants fail to pay the small premium, they’re booted from the program for six months. Pence attempted to get a work requirement approved by the Obama administration, but was unable to do so. These conservative mainstays have made the program the target of significant opposition from some on the left, rather than a rallying point for Obamacare supporters.
In its deeper look at Pence’s home state, the publication also made a glaring omission: the top Trump nominee who created the program in question.
The Healthy Indiana Plan 2.0 was signed into law by then-Gov. Mike Pence, but it was written and structured by Seema Verma, a Medicaid consultant and Trump nominee who’s awaiting Senate confirmation to take the helm at the Centers for Medicare and Medicaid Services. After Health and Human Services secretary Tom Price, she’ll be the top Trump Medicaid official and directly in charge of implementing any Medicaid reforms — and she’s HIP 2.0’s biggest defender.
Politico’s 1200-plus-word discussion of HIP 2.0’s future mentions Verma only once — in an aside — in the second-to-last paragraph. Here it is:
The waiver application, which was largely crafted by Seema Verma, Trump’s pick to lead CMS, is expected to be approved. However, if the ACA is repealed, the program’s future is unclear.
There’s no immediate danger for the program, Politico notes, and current Gov. Eric Holcomb has submitted a waiver to keep the program going, presumably expecting the Trump administration will approve it.
Verma, as Politico briefly mentions, is expected to be confirmed by the Senate. She essentially wrote the law in question and she worked with the state to get it approved by the Obama administration, which didn’t support the more conservative components in the plan.
Though Verma won’t be writing law, as she maintained during some pointed back-and-forths about the Indiana plan, as CMS chief, she’ll have significant latitude in administering the program — and in approving state waivers like her signature Indiana waiver.
With both Pence and Verma in the mix, the two primary architects of the HIP 2.0 program will be leading the Trump administration’s execution of any Obamacare repeal.
Far from it being in danger, since Verma’s nomination, other publications have even looked to Indiana’s plan as the future for Medicaid across the country under the Trump administration.
The dreary outlook in Politico’s piece didn’t even address Verma’s role. Surely the CMS chief-to-be’s involvement in crafting HIP 2.0 merits a little more consideration.
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