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Web letter by Kris Wise: HIP doesn’t have enough ‘buy-in’ to meet state’s medical needs

Since the passage of the Affordable Care Act, there has been resistance, excitement and questions on all sides of the debate. Recently, with the announcement that Gov. Mike Pence received approval to extend Indiana’s Healthy Indiana Plan, I began to question at a new level the motives, lack of credible information and health neglect brought upon the citizens of Indiana.

The Pence administration and supporters tout this as a victory for Hoosiers. They note the “buy-in” factor of the plan because those eligible, enrolled and covered pay 2 percent to 5 percent of their income toward the plan, depending on their level of income. The state notes “(HIP) covers individuals who do not live with a dependent child, and parents who earn up to approximately $47,100 annually for a family of four, have been uninsured for six months, and do not have access to insurance through their employer. There is no asset test. HIP does not cover vision, dental or maternity services.”

As someone who works closely with affected individuals in our community, I see holes in the current arguments. First, you have to be eligible and enrolled in HIP. Eligibility of HIP is not guaranteed, you must be employed. There is a limit to how many individuals can be enrolled in this plan, and you must have been uninsured for six months.

HIP currently offers substandard coverage to its enrollees. Substandard coverage leaves gaps in reimbursement to the health care system.

HIP has operated under a waiting list for the majority of its existence. I have heard arguments that Hoosiers should be happy because HIP was a bipartisan effort. Yes, it was, and it was helpful when there were no other options. Now, Indiana is clinging to a substandard, limited enrollment, and outdated version of what is needed and acceptable for the benefit of our communities.

I can’t help but be focused on the buy-in aspect of this argument. I understand the financial aspect of buy-in, but question its relevance to this argument. The real buy-in is to each individual’s health. When an individual has access to preventive, responsive and comprehensive care, the community’s buy-in is the acknowledgement of human capital. When an individual misses work due to an illness, they cannot seek medical attention and it affects their employer, their family and our community as a whole. The individual buy-in need not only be examined in the financial sense. Their responsibility is their dedication to good health, their responsibility to their family and to our community. When we all buy in to caring for ourselves, adhering to the medical advice and treatment from medical providers, outcomes of others are greater, our economy is healthier and our state sees multiple avenues of enrichment as a result.

There are always financial contributions in all forms of health coverage from employer-based coverage, state entitlements and the upcoming exchanges available through the Affordable Care Act. Extending HIP and denying the extension of Medicaid to Indiana Hoosiers will continue to leave about 330,000 Hoosiers uninsured. Indiana is not alone in this decision but shares its lack of buy-in to human capital with other states.

Perhaps 330,000 uninsured Hoosiers don’t seem like a lot to you? Maybe the 2012 census data will assist in putting it into perspective, as Fort Wayne has 254,555 residents. That’s a large amount of human capital, a large amount of responsibility, and I am willing to buy in to that.


Fort Wayne