Indiana School Health Network
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Healthcare Policy Issues

Enrollment and retention in existing public and private health coverage programs in Indiana are hindered by complex, redundant, unfriendly and uncoordinated application and redetermination systems that do not take full advantage of existing community-based enrollment centers.

Covering Kids & Families of Indiana strives to increase enrollment in Hoosier Healthwise, Medicaid, Healthy Indiana Plan, and private health coverage by simplifying and coordinating the application and renewal process.

Current Issues

The Issue: There are 1,680,000 children under the age of 19 in Indiana. Of these children, about 1 in 10 has no health insurance. That's 161,000 children.

  • Indiana ranked 35th in the nation in 2006 for the number of children living in poverty.
  • Over 14% of Indiana residents do not have health insurance, of which 9% are children.
  • 78 percent of Indiana's uninsured children are members of working families
  • 7 percent of Indiana's children under the age of 6 are uninsured
  • 8 percent of Indiana's children between the ages of 6 and 12 are uninsured; 14 percent of children between the ages of 13 and 18 are uninsured
  • 61 percent of Indiana's uninsured children live in families with annual incomes at or below twice the federal poverty level ($41,304 for a family of four).
  • Indiana has the highest per capita rate of individual medical bankruptcies in the nation.
  • From 1999 to 2005, Indiana had the nation's highest percentage drop in workers who receive employer-sponsored health insurance
  • More than 60% of Medicaid & SCHIP case closures in Indiana are for procedural or compliance reasons, not eligibility reasons
  • Indiana ranked 35th in the nation in 2006 for the number of children living in poverty.
  • Over 14% of Indiana residents do not have health insurance, of which 9% are children.
  • Indiana has the highest per capita rate of individual medical bankruptcies in the nation.
  • From 1999 to 2005, Indiana had the nation's highest percentage drop in workers who receive employer-sponsored health insurance.
  • More than 60% of Medicaid & SCHIP case closures in Indiana are for procedural or compliance reasons, not eligibility reasons.

The state of Indiana recognized the need for making significant changes to the enrollment process for Medicaid and SCHIP (Hoosier Healthwise). They also recognized that changes were needed to the Food Stamps and TANF (Temporary Assistance for Needy Families) programs.

  • Indiana's welfare caseload decreased by only 6 percent in the past decade, making it last in the nation, according to data from the U.S. Department of Health and Human Services.
  • Indiana risks losing $10 million in federal funding if its work participation rate for TANF participants is not 50 percent or higher during federal fiscal year 2007.

High error rates, poor service, outdated technology, and overly burdensome caseloads have plagued the programs within the Family & Social Services Administration. As a result, "Eligibility Modernization" began to take shape. Governor Mitch Daniels and his administration proposed to contract with IBM-ACS to revamp the enrollment process for Hoosier Healthwise, TANF and Food Stamps and would allow simplification and alignment of enrollment policies such as income verification being cross-referenced with other systems, consistent application of eligibility standards, and new, multiple intake points (County Office plus phone, web, mail, fax, email) with transitioned state employee.

The cornerstone of the effort is to improve customer service by making the eligibility application system available 24 hours a day, seven days a week, via an interactive phone system and the Internet. The access by technology would supplement, not replace, the practice of meeting personally with a caseworker in a county office. Clients who want to apply for services in-person with a caseworker could still do so.

Learn about the Health Insurance Marketplace & your new coverage options under Obamacare.

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