Washington Post

By: Phil Galewitz

As the Trump administration moves to give states more flexibility in running Medicaid, advocates for the poor are keeping a close eye on Indiana to see whether such conservative ideas improve or harm care. Indiana in 2015 implemented some of the most radical changes seen to the state-federal program that covers nearly 1 in 4 poor Americans — including charging some adults a monthly premium and locking out some of those who don’t pay for six months.

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Now, advocates worry that the Trump administration is poised to grant Indiana a long-term extension of the Healthy Indiana expansion — and add a requirement that nondisabled adults work or volunteer 20 hours a week. The state also seeks federal permission to lock out any adults who fail — regardless of income level — to renew their coverage in a timely manner. Those changes would “be a big step backwards,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “The problem is when people lose their coverage or get locked out, their health needs do not go away.”

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