Statement of Robert Restuccia, Executive Director, Community Catalyst, on the U.S. Department of Health and Human Services’ announcement today that it has approved the Healthy Indiana Plan, a 1115 waiver to expand Medicaid in Indiana.

BOSTON – “Today’s announcement that the Centers for Medicaid and Medicare Services (CMS) approved Indiana’s proposal to close the coverage gap is good news for the 350,000 Hoosiers who will gain coverage through Medicaid. It is a positive sign that more and more states are recognizing the benefits of accepting federal funding to provide health coverage to low-income people.

“However, as an organization that works to ensure all families can access health care when they need it, Community Catalyst is deeply concerned about certain elements of the Healthy Indiana Plan as approved by CMS. In particular, it is worrisome that the Healthy Indiana Plan will charge significant premiums and penalize some who aren’t able to pay by locking them out of coverage for up to six months. The plan would also charge a significant co-pay to many enrollees, even the lowest-income, when they seek certain Emergency Room services.

“A large body of research demonstrates that premiums and unreasonable cost-sharing requirements impede access to coverage and needed health care services and can lead to increased medical debt, especially for low-income people. These policies could mean fewer Healthy Indiana beneficiaries will get the care they need, and these policies conflict with the underlying objectives of the Medicaid program.

“While it is critical to expand coverage for low-income Americans, the details of these plans matter. Now that Healthy Indiana is moving forward, we strongly urge CMS to closely monitor and evaluate the impact of these policies on Medicaid beneficiaries. Given the significant impact the premium lockout periods and high co-pays for certain emergency room services could have on access to needed health services, CMS should wait for conclusive evidence of the impact of these policies in Indiana before deciding whether or not to approve them in other states.”


About Community Catalyst

Community Catalyst is a national non-profit consumer advocacy organization dedicated to quality affordable health care for all. Community Catalyst works in partnership with national, state and local consumer organizations, policymakers, and foundations, providing leadership and support to change the health care system so it serves everyone – especially vulnerable members of society. For more information, visit Read or comment on our blog at Follow us on Twitter @healthpolicyhub.

Lucy Dagneau
Community Catalyst