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FSSA Secretary Mitch Roob said if the current language is signed into law, Indiana would need to significantly "roll back eligibility" for HIP due to the costs of the program.
Abigail Ruhman / IPB NewsA recent proposal by the U.S. Senate could require Indiana to "roll back eligibility" in the Medicaid expansion program. That's according to the top official at the Indiana Family and Social Services Administration.
The latest version of the federal reconciliation bill places stricter limits on what are known as "provider taxes."
The U.S. Senate proposed a lower cap on those taxes. Under the proposal, states would be prohibited from charging providers — such as hospitals or insurance companies — a fee of more than 3.5 percent to fund Medicaid services.
Indiana currently uses a provider tax on hospitals to cover 90 percent of the portion of the Healthy Indiana Plan, or HIP, that the state is responsible for. For inpatient services, the tax or Hospital Assessment Fee is 6 percent.
FSSA Secretary Mitch Roob said if the current language is signed into law, Indiana would need to significantly "roll back eligibility" for HIP due to the costs of the program.
"You've got a couple choices here," Roob said. "One is reduce the number of eligible people. Continue to create wait lists. I don't like that answer. That may be an answer."
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Roob said another solution would be to pay providers less. But, he said both of those solutions are "unpleasant," so his preference would be for Indiana to find a way to lower the cost of care.
"The current incarnation of the HIP plan is at significant risk," Roob said. "Candidly, we don't have the general revenue fund dollars necessary to make up the difference. If that were to pass, we're going to have some very difficult conversations to have in the coming legislative sessions."
This year, lawmakers passed legislation to address Indiana's low Medicaid reimbursement rate by increasing the Hospital Assessment Fee and creating a new provider tax on the insurance companies that run Medicaid programs in the state. However, the federal proposal wouldn't allow states to create new provider taxes.
Roob said the agency is still working to get approval for the new tax. Recently, Roob said the agency was hoping to do so before the federal government has the authority to deny Indiana's new Medicaid funding structure, but he said the Managed Care Assessment Fee is unlikely at this point.
Abigail is our health reporter. Contact them at aruhman@wfyi.org or on Signal at IPBHealthRuhman.65.
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