Managed Healthcare Executive - February 2009 - (Page 12) {EX EC U T I V E PROFIL E} as of Dec. 4, 2008, which amounts to 98 members per day. More recent data indicates 115 members per day. Charlotte McBeth, JD, MBA, FAHCE, has served as president of MDwise since 1999. She holds a bachelor’s degree in public health, a master’s in health administration and a JD from Indiana University. She also earned an MBA from Butler University. Previous positions include government relations posts for Anthem and the Indiana Health and Hospital Corporation. New Population Pent-up demand for HIP is staggering. State o cials predict the program will eventually enroll a total of 120,000 adults earning less than 200% of the federal poverty level. Any lowincome adult without access to an employer plan who has been uninsured for six months is eligible. As a demonstration project, HIP was designed to open up coverage to low-income adults without children—a unique population that typically does not have access to state Medicaid programs. More than 22,000 adults without children are now on the rolls; however, for that subgroup, HIP has a hard enrollment cuto at 34,000 people. Based on documented demand, it’s almost certain HIP will reach the cap in the rst quarter of 2009. At that point, eligible applicants will be turned away. Because HIP covers underserved adults—who are often the focus of national coverage reforms—its growing pains over the next ve years might provide lessons for incoming HHS Secretary Tom Daschle and the White House O ce on Health Care Reform to observe. “We’ve moved away from a categorical program to one that covers those who have not traditionally been able to get coverage through Medicaid,” McBeth says. “And that is something that is going to be critical for the federal government to look at. The nature of the categorical program will not solve our uninsured problem.” HIP is also the rst plan approved under President Bush’s A ordable Choices Initiative, which, according to a White House press release, directs federal funding to assist states in helping their poor and hard-to-insure citizens a ord private insurance. By allocating federal healthcare funding to help uninsured purchase coverage 12 FEBRUARY 2009 instead of to support hospital care for the uninsured, the initiative does not create a new federal entitlement or new federal spending. In the approval letter from CMS, Kerry Weems, acting administrator, stated that it was allowing Indiana to implement HIP as a test model of health coverage “that emphasizes private health insurance, personal responsibility and ‘ownership’ of healthcare.” aid or SCHIP bene ts pay nothing; they account for more than 34% of enrollees, according to recent state data. All contributions are deposited into an account, known as a POWER (Personal Wellness and Responsibility) account, up to a total of $1,100, which is used to cover the deductible. State and federal matching Medicaid funds pay the balance between enrollees’ contributions and the required deductible. Employers may also contribute up to Personal Responsibility 50% of an employee’s contributions. Several sources fund HIP, including the For example, a HIP member earnmembers themselves. An individual’s ing 150% of the federal poverty level contribution ranges from 2% to 5% of would contribute $624 per year, or $52 income. Individuals with no income as a month. The member’s employer could well as some who receive other Medic- contribute $312 per year, or $26 per ANNUAL POWER ACCOUNT PAYMENTS FOR AN INDIVIDUAL BY INCOME, 2008 State/Federal Payment Enrollee Payment* $1,100 $1,100 $1,100 $892 $1,100 $710 $1,100 $476 $1,100 $60 $0 0% FPL $0 per year $208 100% FPL $10,400 per year $390 125% FPL $13,000 per year $624 150% FPL $15,600 per year $1,040 200% FPL $20,800 per year Family income *Employers may also contribute up to 50% of their employees’ contributions. Source: Kaiser Family Foundation
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