Understanding Indiana's high deductible plan-based Medicaid expansion

One year ago Indiana embarked on its effort to create a Medicaid expansion based on high deductible health plans and health power accounts, called the Healthy Indiana Plan (HIP).  After intense negotiations with the Centers for Medicare and Medicaid Services (CMS), Indiana launched this expansion in December 2007.

On the May 1, 2008 Health Affairs Blog, Mitchell Roob and Seema Verma discuss their work in creating this health reform strategy (Source: Indiana: "Health Care Reform Admist Colliding Values," Health Affairs Blog, May 1, 2008).  Indiana's plan has funding to cover up to 120,000 people.  In its first three months 30,000 people had applied for coverage under the program.

Roob and Verma's  discussion identifies the following six key lessons from their experience:

1.  Inaction is not a market solution

2.  Choose reforms that help those who need it, but also increase personal responsibility and utilize market incentives

3.  Be fiscally responsible

4.  Reach out across party lines and to multiple constituencies

5.  Compromise and cut deals

6.  With the exception of compromise, don't take any of the above lessons too seriously

They conclude their discussion by stating, "The unique structure of the plan holds the promise of redesigning the Medicaid program as we know it today. For the first time, HIP brings recipients and the State together in a market based partnership to use resources judiciously, and to promote provider competition resulting in improved transparency, quality and value for all Hoosiers."