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GARY, Ind. — To better understand what the future of Medicaid could look like, you might come to Indiana. Once you’re here, you might ask someone like Richard Ullrich Jr., who works in a bottling plant, what kind of plan he has through the state’s unique Medicaid expansion.

“I wish I knew,” Ullrich would say.


Ullrich’s uncertainty matters far beyond Indiana these days. The state’s Medicaid expansion under the Affordable Care Act was designed by Seema Verma, a consultant who has been nominated by President-elect Donald Trump to lead the US agency that oversees Medicare and Medicaid. And with congressional Republicans seeking to repeal and replace the ACA and make other changes to Medicaid, Indiana’s system could be seen as a template for a Medicaid overhaul in other states.

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  • Re: Verma has written that HIP 2.0 embraces the concepts of private health insurance, with members “comparing cost and quality of health care services” because they are contributing to their plans.

    We would all love to know the cost and quality of health care before we interact with the system. What a revolutionary idea! I would love to hear how that’s done and what the impact is. But I fail to see the point if Verma is just showing Medicaid enrollees the bills afterward. That’s not change, just more bureaucracy.

    In my opinion, this ‘skin in the game’ thing is paternalistic and insults the dignity of people who just happen to be poor. CMS is already known for it’s bureaucracy. Add all of this on top and I think we’re going to see serious health care gridlock…

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