INDIANAPOLIS (AP) -- Nearly 300,000 adults could be left uncovered by the federal health care overhaul if Indiana chooses not to expand its Medicaid program following the Supreme Court's health care ruling, according to a published report.
Indiana Medicaid only covers adults under 65 if they have children and their household income is only 24 percent of the federal poverty level, or about $5,800 per year for a family of four, the Indianapolis Business Journal reported Sunday. Adults without children are not eligible at all under existing Indiana Medicaid programs.
The court ruling last week gave states the option of going along with a Medicaid expansion that would cover families with incomes up to 133 percent of the poverty level, an amount equivalent to $14,856 annually for an individual or $30,657 for a family of four.
The Business Journal reported that families slightly over the poverty level would still be eligible for government subsidies to buy private health insurance even if Indiana chooses not to expand coverage.
But if Indiana doesn't expand its Medicaid coverage, families with incomes between 24 percent and 100 percent of the poverty level couldn't get either Medicaid or subsidies, the Business Journal reported.
That would leave about 290,000 adults, who would have qualified for the new coverage, without options.
"That's very worrisome to us," Indiana Hospital Association CEO Doug Leonard said about the possibility of Indiana not expanding its Medicaid program.
"That was really the heart of the bill for us."
The health care law pledged Congress to pay the entire cost of the Medicaid expansion from 2014 to 2016, and then required states to pay 10 percent by 2020.
But the court ruled that the federal government couldn't take away states' existing federal Medicaid dollars if they refused to widen eligibility to include adults who are only slightly above the poverty line.
Republican Gov. Mitch Daniels said after the ruling was announced Thursday that it would be up to future legislators and the next governor to decide whether to go along with the Medicaid expansion.
Daniels still has a request pending to use the Healthy Indiana Plan as the vehicle for expanding Medicaid.
HIP uses personal health savings accounts.
But Indiana Senate President Pro Tem David Long, also a Republican, asserted that the state "will certainly" opt out of the Medicaid expansion.
The Business Journal reported the 290,000 potentially uncovered adults are also the patients most likely to not pay their hospital bills.
And while Medicaid pays only about 60 cents on the dollar, that's better than the 10 cents or less hospitals typically collect on unpaid bills. Most hospitals would probably simply write off that care as charity and collect nothing, according to the Business Journal.
"Clearly, for our industry, we would rather see the coverage in Medicaid," Leonard said.