Indiana

Indiana health insurance marketplace: history and
news of the state’s exchange

BCBS of Indiana and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

More Indiana coverage

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    Insurance Guide
    • A guide to health insurance in
      your state.
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    Medicaid
    • Your state’s Medicaid expansion,
      eligibilty, contacts
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    Medicare
    • Insurance for those over 64
      (off-site)

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Indiana exchange overview

In 2017, the average premium in Indiana dropped 3% while the individual market increased 18.9%. A majority of the counties in Indiana have three or more insurers and in combination with the Affordable Care Act, there were lower rate increases for this year.

Indiana and the American Health Care Act

The American Health Care Act was introduced in March 2017. Its goal was to change some of the provisions of the Affordable Care Act. If the act was enacted, it was estimated that premiums would raise 15-20% in 2018 and 2019. It was also predicted that 24 million people would be uninsured—365,500 of them would be Indiana residents. However, due to high number of oppositions by the Democrats, the act was never passed.

 

Health Ratings

In 2017, Indiana ranked 39th place on the Scorecard on State Health System Performance. Additionally, the state ranked in the third and fourth quintile for all five categories: Access, Prevention & Treatment, Avoidable Hospital Use and Cost, Healthy Lives, and Equity. The state ranked 48th for public health funding and 36th for policy which is: Lack of Health Insurance, Immunizations for Children, Immunizations for Adolescents, and Public Health Funding.

Indiana and Obamacare

The state of Indiana has a federally facilitated exchange—meaning its residents use HealthCare.gov to purchase health insurance plans. This is all due to the Affordable Care Act. In 2017, 403,142 people had enrolled in Medicaid due to the Medicaid expansion that took place in 2015. In 2017, there was an 11% decrease in open enrollment. As of 2016, 83% of enrollees were receiving premium subsidies. If that information is still accurate for the 2017, then we can estimate that 145,000 people in Indiana receive premium subsidies. In conclusion, there are about 450,000 people in Indiana who are receiving financial help.

Rates and Insurers

In 2017, there were four insurers who left the Indiana exchange. The four remaining insurers include:

  • Anthem BCBS
  • CareSource Indiana
  • Celtic
  • MDWise

Even with the loss of four insurers, plan rates in the exchanged dropped 3% despite state regulators approving an 18.9% weighted rate increase for 2017.

 

Medicaid and Indiana

From 2013 to 2016, Indiana Medicaid enrollment increased by 31% (349,336). However, the state made modifications that hindered the number of people who would otherwise enroll. Indiana has two levels of Medicaid coverage: HIP Basic and HIP Plus. Plus includes dental and vision with no co-pays (no including the use of emergency rooms for non-emergency care). Basic has co-pays and doesn’t include dental or vision coverage. Those who are above poverty level can enroll in HIP Plus and are required to pay premiums. Those who are below poverty levels can enroll in HIP Basic without premiums. This has caused around 30,000 people who are eligible for Indiana Medicaid but haven’t finalized their reenrollment because they haven’t paid their premiums.

 

Risk Pool

The Indiana Comprehensive Health Insurance Association was created in 1982 to give residents an alternative for health coverage for those who were unable to get health coverage due to a pre-existing condition. The Affordable Care Act meant that people could purchase health coverage regardless of the medical history. The Indiana Comprehensive Health Insurance Association stopped enrolling member in 2013—right before the Affordable Care Act passed.

 

Medicare enrollment

As of 2015, Indiana Medicare enrollment was 1,150,553 residents—about 17% of the state’s population. Annually, Medicare spends about $9,141 per enrollee which is higher than the national average. Additionally, Medicare spends about $9.7 billion per year in Indiana.

 

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.