A group of nonprofit organizations sent a letter to Indiana Governor Eric Holcomb this week, urging him to reconsider a new work-requirement rule in the state's Medicaid expansion program, Healthy Indiana Plan, or HIP.
More than 400,000 Hoosiers are currently enrolled in HIP. Last month the state became the second state to receive federal permission to add a work requirement to its program.
HIP dropped the state's uninsured rate from 14 percent in 2013 to 8 percent in 2016 after the program was expanded to include more adults in February 2015.
Director of Indiana Institute for Working Families Jessica Fraser said adding similar requirements for other programs like SNAP, previously referred to as food stamps, and TANF — Temporary Assistance for Needy Families — haven’t worked.
"What tends to happen is that we don’t see big numbers of poverty reduction, we don’t see big numbers of labor force participation climbing, but what we do see is a lot of folks losing those benefits," Fraser said.
The group says most people on HIP who can work are already doing so, and they say many will be also be unable to navigate the requirement process and could end up being locked out of their insurance.
"Based on our experiences and observations in the Indiana communities we serve, we can assure you that many Hoosiers will fall through the cracks," the group wrote. "They will be kicked off the only health care program they could possibly obtain. They will suffer with pain and illness unrelieved by medicines or a physician’s care. Some will die as a result."
Indiana's plan, approved by federal regulators in February, would lock people out of Medicaid coverage for six months for failing to pay premiums for their coverage or for three months for failing to complete the eligibility renewal process, according to the Kaiser Family Foundation.
Fraser says the state should instead address work barriers.
"We need to figure out what those barriers are, some of them are academic, some of the non-academic but we know that skills training is in the mix and work on those barriers instead of having mandatory work requirements," Fraiser says.
Indiana’s rule does have a number of exemptions to the work requirement, including for people who are going to school or caring for a disabled adult or child.
The work requirement changes will not go into place until 2019.
The group of organizations calling on Holcomb to reverse the work requirement decision includes the Indiana State Conference NAACP, Concerned Clergy of Indianapolis, Indiana Institute for Working Families, Hoosiers for a Commonsense Health Plan, Faith in Indiana (formerly IndyCAN) and People of Faith for Access to Medicines.
This story was produced by Side Effects Public Media, a reporting collaborative focused on public health.