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More than a half-million people in Indiana have jobs but no health insurance, and the Indiana Family and Social Services Administration is trying to determine what, if anything, should be done about it.
Agency officials discussed the issue with lawmakers, insurers, medical providers and others Wednesday, the same day the Massachusetts governor signed into law a bill designed to guarantee virtually all of that state’s residents have health insurance.
The four-hour meeting in Indianapolis was the first stop in a six-week, 11-city tour during which state officials will listen to people’s concerns about health insurance coverage. A bill the General Assembly passed this year requires the FSSA to develop a plan to provide coverage to more low-income adults in time for next year’s session.
Medicaid and Hoosier Healthwise offer coverage to some children and seniors who otherwise could not get health care, but 561,000 Hoosiers still don’t have medical insurance, according to FSSA estimates.
The state has lost 138,000 jobs since 2000 _ mostly in industry, which provided good health benefits, state figures show. Many who lost their jobs now work in the lower-paying service sector that provides lesser benefits or none at all.
“If you’re not covered by your employer … and you’re not covered by Medicaid … health insurance in Indiana is unaffordable,” said Charles Warren, a researcher for the Indiana Coalition on Housing and Homeless Issues, a nonprofit advocate of the working poor.
FSSA must first build consensus that the problem is large enough to require state intervention and then provide a solution, agency Secretary Mitch Roob said.
“We’ve got to have a very frank conversation about where to begin,” he said.
Roob believes the problem warrants attention, he said. But it also means the government, health care providers, insurers and others must agree on how to address it.
Some approaches that might be considered are expanding state Medicaid coverage to include more adults, setting up some sort of catastrophic care plan, tax breaks and medical savings accounts, or combining some or all of them.
Warren said he believes Indiana should consider using as a model the Massachusetts plan that Gov. Mitt Romney signed into law Wednesday. Massachusetts will offer free or well-subsidized coverage to poor and lower-income people. Those who can afford insurance but still refuse to get it will face escalating tax penalties.
One key decision that will have to be made in Indiana, Roob said, is where to draw the line for eligibility. The state generally uses 200 percent of poverty level _ about $40,000 for a family of four, he said.
But Warren suggested that line might not be high enough because of how much the coverage costs.
Citizens Action Coalition Executive Director Grant Smith said the problem is national and requires a national solution.
“The situation’s just going to get worse,” he said. “The current system has just obviously failed.”
Roob doesn’t see the problem going away, either.
“Health care cost growth is such that in the long run we will have to deal with this issue,” he said.
But 2007 may not be the time, he said. The first slide of the presentation he prepared for lawmakers acknowledged that “the cure could be worse than the disease.”
“If the answer at the end of the day is, ‘We’re not ready to do that,’ I’m OK with that,” Roob said.