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. Author manuscript; available in PMC: 2018 Aug 4.
Published in final edited form as: Health Aff (Millwood). 2018 Jun 20;37(7):1099–1108. doi: 10.1377/hlthaff.2018.0331

EXHIBIT 1.

Features of Medicaid programs in Indiana, Ohio, and Kansas, December 2017

Indiana
HIP 2.0 Basic HIP 2.0 Plus Ohio Kansas
PROGRAM FEATURES

Adult eligibility criteria Family income ≤138% of FPL Family income ≤138% of FPL Parents with family incomes ≤38% FPL; disabled adults with family incomes ≤75% of FPL
Premium/required contribution 2% of income, or $1 per month for those with incomes 0–5% of FPL None None
Copayments Graduated payments for nonemergency use of ED: $8 for first visit, $25 for any subsequent visit in same year; payments for other services based on state’s traditional Medicaid plan None Based on state plana None
Annual deductible $2,500 None None
Health savings accounts $2,500 allowance in account used to meet deductible before other plan benefits become effective; enrollees who make payments on time can roll over any unused portion and use it to reduce monthly payments in the following year None None
Penalty for failure to make payments Those with incomes 101–138% of FPL are disenrolled and locked out of the program for 6 months; those with incomes ≤100% of FPL are moved from HIP Plus to HIP Basic, with higher cost sharing and fewer benefits Not applicable Not applicable

BENEFITS

State’s traditional Medicaid plan Yes Yes Yes Yes
Vision or dental No Yes Yes Yesb
Other Less generous prescription drug benefit More generous prescription drug benefit

SOURCES Authors’ analysis of data from the following sources: (1) Musumeci M, et al., An early look at Medicaid expansion waiver implementation in Michigan and Indiana (see note 7 in text). (2) Zylla E, et al. Section 1115 Medicaid expansion waivers (see note 37 in text). (3) Brooks T, Wagnerman K, Artiga S, Cornachione E, Ubri P. Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies as of January 2017: findings from a 50-state survey [Internet]. San Francisco (CA): Henry J. Kaiser Family Foundation; 2017 Jan 12 [cited 2018 May 21]. Available from: https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-renewal-and-cost-sharing-policies-as-of-january-2017-findings-from-a-50-state-survey/. (4) Henry J. Kaiser Family Foundation. Medicaid financial eligibility: primary pathways for the elderly and people with disabilities [Internet]. San Francisco (CA): KFF; 2010 Feb 25 [cited 2018 May 21]. Available from: https://www.kff.org/medicaid/issue-brief/medicaid-financial-eligibility-primary-pathways-for-the-elderly-and-people-with-disabilities/. NOTES Indiana and Ohio expanded eligibility for Medicaid through the Affordable Care Act; Kansas did not. Healthy Indiana Program (HIP) 2.0 Basic and Plus are explained in greater detail in the text. Information on pregnancy-related coverage is not included. FPL is federal poverty level.

a

Section 1931 parents: $3 for nonemergency emergency department (ED) visits, $2 for preferred brand-name drug prescriptions, and $3 for nonpreferred brand-name drug prescriptions. Expansion adults: $3 for nonpreferred brand-name drug prescriptions.

b

Some managed care plans cover vision and dental services.