Why Indiana’s tough Medicaid bargain may be the only way the Obama administration can insure millions in need.
By Alec MacGillis
These may not sound like big sums or onerous requirements. But advocates for universal health coverage are worried that they’ll deter Hoosiers from actually seeking coverage and care, because studies have found premiums and copays, even small ones, have a highly deterrent effect on the poor, which is why Medicaid has generally steered clear of requiring them. “Medicaid was designed to make this coverage work for low-income people,” says Leonardo Cuello, director of health reform for the National Health Law Program. Judy Solomon, of the Center on Budget and Policy Priorities, worries that the sheer complexity of the plan—which also includes a health savings account where people are supposed to save for health costs—will keep many Hoosiers away. It’s ironic that in making Medicaid more conservative, Pence has made it much more complicated and bureaucratic: “They’re going to have thousands making these tiny contributions, and then [the state] makes tiny payments to lots of providers. The transaction costs have got to be enormous,” says John Holahan of the Urban Institute. Read the full article here. »