'It's the kind of health reform that puts working Hoosiers in the driver’s seat,' Pence says. Pence proposes Medicaid expansion

Indiana Gov. Mike Pence, whose rising national profile is feeding 2016 presidential buzz, has become the latest Republican governor to embrace a core component of Obamacare — with a conservative twist.

Pence, like Ohio Gov. John Kasich and New Jersey Gov. Chris Christie before him, announced a major push Thursday to expand Medicaid under the health care law and follow 26 states that have extended coverage to a larger share of their low-income residents.


Pence outlined a blueprint Thursday for a version of expansion that includes a laundry list of conservative-friendly reforms adopted in other red states. Among them: placing enrollees in private insurance instead of traditional Medicaid, requiring some enrollees to pay modest premiums, conditioning enrollment for some on paying into a health savings account, encouraging unemployed or underemployed beneficiaries to pursue work opportunities and attempting to limit overuse of the emergency room.

At a news conference in an Indianapolis hospital’s auditorium, Pence called his proposal “the kind of health reform that puts working Hoosiers in the driver’s seat.” The proposal is set for a 30-day state review before it heads to Washington for a review by CMS.

If the proposal or some version of it is ultimately approved, it would harness billions of Obamacare dollars to help cover an additional 350,000 low-income residents. The federal government will pay the full cost of expansion through 2016 and gradually require states to pay up to 10 percent in subsequent years.

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Pence intends to build the expansion on top of an existing state program called the Healthy Indiana Plan, and his office took great pains to distance the effort from an embrace of the core provision of Obamacare. In fact, a summary of the proposal describes it as a move to “eliminate traditional Medicaid” for non-disabled Hoosiers.

“Expanding the Healthy Indiana Plan will alleviate the coverage gap created by the Affordable Care Act,” according to Pence’s office.

Yet the Obama administration labeled his move a “Medicaid coverage expansion.” It praised Pence, a vocal critic of Obamacare, for taking steps to join the states that have gone down the same path.

“We are encouraged by Indiana and Gov. Pence’s commitment to helping cover more of the state’s uninsured population through the Healthy Indiana program and look forward to seeing his proposal,” said Emma Sandoe, a spokeswoman for the Centers for Medicare & Medicaid Services. “In Indiana, it would mean coverage for thousands of additional Hoosiers.”

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If the waiver request is approved, Pence would become the eighth Republican governor to expand his state’s Medicaid program. Others include conservatives Jan Brewer of Arizona and Rick Snyder of Michigan. Tom Corbett of Pennsylvania is pursuing a similar plan that’s under review by CMS as well.

Pence also plans to submit a waiver request to CMS to continue the Healthy Indiana Plan in more a limited form, in case the feds reject his expansion proposal. He intends to cover the state’s share of Medicaid expansion costs using revenue from an existing cigarette tax and an assessment on hospitals. The expansion would automatically end if the promised level of federal support shrinks.