Our View: State failed Hoosiers on Medicaid

Beginning Dec. 31, about 300,000 Hoosiers will need to find a new Medicaid insurer.

This deadline comes as Gov. Mike Braun’s administration works to control the rising costs of Medicaid. Projections show a 9.5% increase during the current fiscal year and 7.7% in the next.

Currently, four main insurers cover Medicaid’s 1.7 million Hoosiers. Among the four, Anthem covers 36%, with MDwise and Managed Health Services following at 17% each. CareSource is at 9%.

The state is ending its contracts with Indianapolis-based MDwise a year earlier than the contract sunset of Dec. 31, 2026. Indiana’s Family and Social Services Administration claims MDwise is the most expensive of the plans and has the lowest performance.

However, the state has issued no analysis of cost savings in ending the contract. MDwise has sought an injunction against the state agency, arguing that it arranges medical care for more than 300,000 Hoosiers.

MDwise serves as the managed health care plan for Indiana Medicaid’s Healthy Indiana Plan (HIP) and Hoosier Healthwise, which is for pregnant women and children up to the age of 19. HIP serves low-income adults between 19 and 64 who do not qualify for Medicare or other Medicaid.

The two contracts with FSSA provide $1.7 billion in annual revenue for MDwise. The revenue is derived from a monthly premium paid by the state to MDwise for each enrollee. MDwise estimates that 238 employees will permanently lose their jobs.

FSSA claimed in a press release that the action was necessary to “ensure long-term strength and sustainability of Indiana Medicaid.”

One bright spot might seem to be that the state will automatically assign eligible Hoosiers to one of the three remaining insurers.

But that may not be the preferred choice for some. The responsibility then falls on Hoosiers who, to be honest, might be too ill to seek options on their own. Many, too, might fall through the cracks and become uninsured after a 90-day grace period.

Although both FSSA and MDwise had discussions as early as Aug. 18, the public didn’t get official notice of the break until Nov. 12.

Six weeks is not an adequate cushion of time for Hoosiers being kicked off one health plan to go shopping for another, especially when that hunt includes major holidays. More advance notice should have been given, even up to a year to prepare for a major life change.

Braun’s FSSA is wise in seeking ways to trim the cost it pays for contractual programs. But this is mandated service that keeps thousands of Hoosiers alive.

Six weeks is too short of a time for many Hoosiers who have depended upon MDwise to help keep them healthy.

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