Pence seeking help from Congress in Medicaid dispute
Gov. Mike Pence has accused the Obama administration of hiring a biased contractor to evaluate Indiana's HIP 2.0 program.
WASHINGTON – Gov. Mike Pence wants Congress to get involved in his dispute with the Obama administration over the evaluation of Indiana’s alternative Medicaid program.
Pence has accused the administration of hiring an evaluator that is biased against Indiana’s approach.
“We have no confidence in any result that would be generated by that evaluation,” Pence said during an interview while attending the National Governors Association’s winter meeting in Washington, D.C.
Indiana is one of a handful of states that received permission to not follow some federal rules when expanding Medicaid coverage under the Affordable Care Act.
Indiana’s permission runs through Jan. 31, 2018.
One of the conditions of such waivers is that the demonstration program be evaluated to see whether it’s meeting the expected result. Indiana must submit an interim evaluation of the program by mid-2016.
For example, Indiana is testing whether requiring participants to make monthly contributions to a health account that can be rolled over if not used for health care reduces the use of unnecessary care.
That feature is based on high-deductible insurance plans with health savings accounts that are becoming increasingly common in private insurance coverage.
Pence argues that the Urban Institute, one of the evaluators chosen by the federal government to assess Indiana’s plan, has previously been skeptical of using the health savings account model for Medicaid recipients.
Pence wrote Health and Human Services Secretary Sylvia Burwell in December, asking that the federal review be dropped as the Healthy Indiana Plan has already been evaluated by a state-hired contractor.
Pence: U.S. evaluation of state�s alternative Medicaid plan is unfair
In a Feb. 10 response, Burwell said the federal evaluation will not duplicate the state’s analysis, and a rigorous evaluation will help the federal government determine whether other states should be allowed to use Indiana’s model.
Burwell also said the Centers for Medicare and Medicaid Services followed federal rules for choosing the federal evaluators, which include the assurance of impartiality.
“CMS’s process ensures that federal evaluations are objective, independent and rigorous,” Burwell wrote.
Pence said he is “wholly unsatisfied” with that response, and will ask the GOP-controlled Congress to review the agency’s vendor selection process.
While Pence said Burwell always worked in good faith with him while they negotiated the terms of Indiana’s alternative program, there are people “deep in the bureaucracy” who are “very antagonist towards consumer driven health care.”
“The administration wanted Indiana — and still wants every state — to just expand traditional Medicaid,” he said. “We have the most significant Medicaid reform in the 50-year history of the program, and it’s working.”
A coalition of health care and other advocacy groups wrote a letter last month in support of the federal government’s evaluation of HIP 2.0. The coalition — which includes Families USA, the March of Dimes and the American Cancer Society Cancer Action Network — said there can be a conflict of interest with state-contracted evaluations.
“When a state pays an organization to assess the merits of its own program there is the potential that the evaluator’s objectivity will be compromised,” the coalition wrote to the director of the Center for Medicaid and CHIP Services.
The groups said aspects of Indiana’s program are potentially harmful to beneficiaries and need to be evaluated before the federal government decides whether other states can adopt them. Those features include the option of charging monthly payments to recipients below the poverty line, blocking coverage for those above poverty who miss their monthly payments, and the overall complexity of HIP 2.0.
Pence said he’s hopeful November voters will elect a new president who would work with Congress to give states greater flexibility to run their Medicaid programs.
Contact Maureen Groppe at mgroppe@gannett.com or @mgroppe on Twitter.
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