Under Trump, Indiana May Export Free Market Medicaid Expansion

John Commins, December 21, 2016

Seema Verma, the presumptive next administrator of the Centers for Medicare & Medicaid Services, is the architect of Indiana's free market-based Medicaid waiver program. Hospital executives in the Hoosier State believe it could be easily adopted elsewhere.

This is part of a series covering the Shaping of Healthcare's Future in the Trump era.

Under Trump, Indiana May Export Free Market Medicaid Expansion

It is no small irony that the Medicaid expansion envisioned under the Affordable Care Act may come to fruition in many of the remaining 19 non-expansion states only after the man who's pledged to repeal Obamacare takes office.

Elected leaders in these 19 Medicaid non-expansion states have refused billions of dollars in federal funding to expand the program because of ideological and political reasons.

They object to what they see as the government's increasingly intrusive role in providing and paying for healthcare under a program that they believe is unsustainable, and they don't want to help Democrats enable Obamacare.


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Those objections could evaporate when President-elect Donald Trump's nominee Seema Verma becomes administrator of the Centers for Medicare & Medicaid Services.

Verma, a private sector consultant from Indianapolis, has built a strong resume as a conservative policy wonk, primarily because of her use of free-market principles to craft the Healthy Indiana Program 2.0, or HIP 2.0, a three-year Medicaid demonstration project, at the behest of Republican Gov. Mike Pence, the vice president-elect.

"In a sense HIP 2.0 is not much different from any commercial plan with high deductibles and requirements for patient participation," says Doug Leonard, president of the Indiana Hospital Association.

Leonard says Indiana hospitals were surprised and pleased that Pence, an avowed opponent of the ACA, came to support Medicaid expansion, but only on his terms.

"Being a very conservative governor, he stated frequently his opposition to the ACA. We didn't anticipate his willingness to consider the coverage expansion," Leonard says.

John Commins

John Commins is a senior editor at HealthLeaders Media.

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