Fox's Problematic “Solution” To Obamacare

Fox News touted Indiana's health insurance plan, the Healthy Indiana Plan, as an alternative to the Affordable Care Act, but ignored the significant problems with the plan, including barriers to care for lower-income individuals.

On the August 28 edition of Fox & Friends, co-host Brian Kilmeade hosted Indiana Governor Mike Pence (R) to plug HIP, a program passed by former Indiana Governor Mitch Daniels (R) in 2007. Kilmeade suggested that HIP is “a sign the federal government needs to leave health care up to the states,” and concluded: “So much you can learn from Indiana.” During the segment, Fox aired a caption declaring HIP a “solution to Obamacare.”

The Indiana plan has a number of problems, which were left unmentioned by Kilmeade and Pence.

The program caps the number of people that can enroll. For that reason, according to Gannett's Maureen Groppe (via Nexis), HIP has “gotten four times as many applicants as the approximately 105,000 Hoosiers it has served.” In a July article, Groppe noted that while roughly “37,000 Hoosiers are enrolled in the program and another nearly 53,000 are on a waiting list,” over “400,000 Hoosiers could get health insurance under Medicaid” if Indiana expands Medicaid under the Affordable Care Act.

Furthermore, in an article headlined “Indiana faces crossroads on health care for poor,” Groppe explained that HIP relies on “increased cost sharing to keep costs down.” That cost sharing, however, “creates a barrier to care” for those with low incomes (via Nexis):

Advocates for the poor say the cost-sharing creates a barrier to care.

Fran Quigley, an Indiana University law professor who has tried to help those who lost HIP coverage get reinstated, said that while a minimum $160 a year contribution sounds reasonable, low-income families have no room for financial error. A family or housing crisis can make them unable to find the money for even essential matters, he said.

“I understand the cost savings and personal investment theories behind the promotion of health savings accounts and premium requirements,” Quigley testified at a public hearing on the state's request to continue the program. “But the punitive loss of coverage due to a family financial crisis, and the inevitable spike in taxpayer-shouldered costs for emergency room visits by persons unable to obtain primary care, are exactly the outcomes the (enrollment fee) prohibitions under federal law are trying to prevent.”

According to Groppe, HIP also attempts to lower health care costs “by limiting some of the traditional Medicaid benefits and by capping the total value of benefits that recipients can receive each year and during their lifetime.” For example, maternity care, as well as dental and vision coverage, are not covered by the program.

Writing in Kaiser Health News in March 2011, The New Republic's Jonathan Cohn explained several problems with HIP:

For what it offers, it's expensive. Partly that's because it pays providers better than Medicaid, which is a good thing; and partly that's because it's not attracting enough healthy people into the program, which is not such a good thing. At the same time, Healthy Indiana doesn't seem to be providing better management of chronic disease, which is what the low-income population really needs.