Under Obamacare, states have the option to expand Medicaid to allow more low-income people to be insured. Thirty-two states and the nation’s capital have expanded Medicaid.
As governor of red state Indiana, Vice President Mike Pence took the money and expanded Medicaid but required enrollees to pay for part of their coverage — a form of Medicaid expansion with conservative compromises. The payments go into health care savings accounts.
Politico reported that Republicans’ and Democrats’ concerns about Indiana’s expansion have defied the expected (emphasis added):
Two years later, as the program emerges as a national model thanks to Pence’s role in the Trump administration, the reality on the ground shows what happens when political philosophy collides with the practical challenges of providing health care to tens of thousands of people, many of them in crisis.
Advocates for the poor in Indiana argue that liberal fears of depressed enrollment were overblown. More than 400,000 Hoosiers are enrolled, despite state requirements that low-income residents make nominal monthly contributions to their care or face stiff penalties.
Likewise, Republicans’ contention that the system would promote personal responsibility and prod beneficiaries to ration their care and make better decisions about what treatments to seek also turned out to be overly optimistic.
The Healthy Indiana Plan 2.0 could also serve as a model for congressional lawmakers as they grapple with repealing Obamacare.