WILL INDIANA BE “HIP” OR UP THE CRICK?

The Author attended an Affordable Care Act (Obamacare) seminar yesterday. It was very well presented by Doug Powers of the firm of Beckman, Lawson, LLP.

Here are some points that we can all take away:

A.   The Affordable Care Act (ACA) is the law of the land. It will likely be tweaked, but it is a done deal, a fait acompli.  It is the medium-term future of American healthcare.

B.   There are numerous components to the ACA, but one is health exchanges for the uninsured to buy “reasonably priced insurance.” The ACA envisioned that states would operate them. Many states will, some states will not, and some states will operate them jointly with the federal government, or as Professor Cox used to call the “G,” “Uncle Sugar.” Indiana will let the federal government operate its health exchange.

C.   Medicaid Expansion. One of the key components of the ACA is the expansion of Medicaid. Medicaid under the ACA was to insure people between 100% and 133% of the poverty line. People above that line can go to the exchanges and get subsidies.

1.    The US Supreme Court held that states could not be forced to expand Medicaid. So some states are, some states are not, and some are trying to get their current Medicaid Waiver Plans approved as a Medicaid expansion. Currently, Indiana is trying to gets its Healthy Indiana Plan (HIP) approved as a method of Medicaid expansion. Uncle Sugar did extend the plan but did not get blanket approval for HIP.

2.    Some states are appearing to have some success with convincing Uncle Sugar (through the Center for Medicaid and Medicare Services (CMS)) to approve state plans. Arkansas is having some success.

D.   The Author will close the article with some political cartoons courtesy of Doug’s powerpoints and another of Doug’s powerpoints placing the ACA within a political left and right framework. HINT: The ACA is right of center. It ain’t socialized medicine, gentle readers.