"I think that's something a lot of people grapple with," Taylor said. "I just think of all the ways my life would've been different if I had had affordable care."
Before 2015, neither woman had health insurance. They fell into the coverage gap -- their income disqualified them from
"As a grad student, I can't work a lot, so I don't have a very significant income," said Gilland, who is attending
Gilland, who was covered by
Still, among the HIP-insured population, the state saw a drop in unnecessary emergency room visits, and the program cost less than traditional
In 2012, the
"We are leading the country in
In the year since the program began, more than 374,000 low-income Hoosiers are now on HIP health insurance plans. As of
"When I get sick, I'm not avoiding the doctor like I used to because I didn't want to pay large amounts out of pocket," said Gilland, who was able to sign up for HIP after the state's waiver was approved, as was Taylor.
Through the help of state-licensed navigators who work with area nonprofits,
"In some surrounding counties, we could be doing a lot better," he said. "We know there are a lot of unmet needs out there."
Even HIP's staunchest critics can acknowledge the program's success based on how many people are now insured within the state's most vulnerable population, said
HIP 2.0 members are required to contribute small amounts of money based on income to their POWER accounts monthly in order to receive the state's top benefits package, HIP Plus. Members who do not contribute to their POWER accounts are downgraded to the HIP Basic plan and lose vision and dental visits and have copays for health services.
Both plans mandate members to pay an increasing copay for every unnecessary emergency room visit, and Moser said that traditional
No other form of
Having "skin in the game," Moser said, makes members more engaged in their health care experience, and improves access and quality of care.
"My concern is that having 'skin in the game' is ultimately only going to put up another barrier to keep people from getting needed care," Stone said.
In the first year of HIP 2.0, 70 percent of HIP enrollees made contributions to their POWER accounts, Moser said, and the average monthly contribution was
Gilland and Taylor's experiences on HIP align with the rest of the state's response to the program in its first year. Moser said 86 percent of Hip Plus said they were satisfied, 94 percent said they would re-enroll and 83 percent said they would be willing to pay more to be in the HIP program.
Local social service providers told Moser their clients still face barriers to using HIP 2.0 to its full extent to get the care they need. For individuals who haven't had insurance for long periods of time, HIP 2.0 doesn't always cover all of the medical and dental procedures they need to regain their health.
In order to assist their clients with signing up for HIP 2.0, case workers, volunteers and other navigators have to spend the time and money to be certified in compliance with state law.
"We had to make some tough decisions, and we had to make some tradeoffs," Moser said.
The state is looking into addressing the need for additional primary care physicians by allowing nurse practitioners to see patients, as well as bolstering the amount of Spanish-speaking navigators in communities, Moser said.
Taylor, who was eligible for marketplace plans during the last open-enrollment period, is now working to be certified as a navigator to help others not face the same insurance frustrations she did before HIP 2.0 expanded.
"You can prevent snowballing long-term costs down the road," Taylor said. "I'm a walking example."
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