Current Situation
As the COVID-19 pandemic set in, Medicaid beneficiaries across the United States gained protection in the form of “continuous enrollment.” With additional federal funding, the state of Indiana not only kept Medicaid members continuously enrolled since April 2020, but also suspended the premiums and copayments that members pay for the Healthy Indiana Plan (HIP), which provides coverage to low-income adults. As a result, HIP enrollment increased by 90% as of Jan. 2023 to over 800,000 people. Starting in April 2023, Medicaid rules return to normal. Based on a pre-pandemic community-engaged study of HIP, our research team knows that many people will struggle to navigate these rules, potentially leading to tens or hundreds of thousands of eligible people losing health benefits.
The Project
With the return to normal Medicaid rules, the research team of Dr. Elaine Hernandez, Assistant Professor of Sociology, IU; Dr. Ivan Douglas Hicks, Pastor, First Baptist Church North Indianapolis; and Dr. Craig are launching a statewide study, funded by the Robert Wood Johnson Foundation. The team seeks to understand how enrollment patterns and health care utilization may have changed for HIP members from minoritized racial and ethnic groups. The three-year suspension of key administrative burdens offers a “natural experiment” to examine shifts in enrollment and utilization trends. Interviews with HIP members will spotlight people’s health experiences during continuous enrollment as well as new challenges with the return of program rules. Our community-valued research will engage community leaders in cities across Indiana to map the local institutions through which HIP-eligible people do or do not access health care to identify effects of structural racism on health equity.
This project depends on many community and university partners and builds on previous research. Our 2019 study engaged current and potential HIP members for their expertise on how HIP was working or not working as they sought to enroll in the program and use its health benefits. Community partners, First Baptist Church North Indianapolis and Shepherd Community Center, centered the experiences of Black beneficiaries. Participants identified important helps, including direct assistance from navigators, social workers, and care coordinators along with ongoing support from trusted community organizations. They also identified hindrances, including a series of administrative burdens from application processes, document handling, and financial payments to other barriers with transportation, stigma, and stress.
Dr. Craig and Prof. Pamela Napier (Visual Communication Design, Herron) were awarded the 2020-21 IUPUI Bantz Community Fellowship to advance on one of the Recommendations from the 2019 study. We partnered with congregational leaders, advocacy groups, and insurance outreach teams to co-create a suite of brochures to raise public awareness and visually communicate how to get, keep, and use the medical, vision, and dental benefits of HIP Plus.
Humanitarian Impact
The Healthy Indiana Plan’s name promises a healthier state. If every eligible Hoosier can get, keep, and use the more comprehensive HIP Plus plan, members can benefit from regular wellness care and chronic disease management along with the financial security of avoiding onerous bills and medical bankruptcy. Better health outcomes and fewer expensive trips to the Emergency Department can benefit everyone. This research will make recommendations for HIP program changes and offer paths toward remediation for other systemic problems discovered that impede better community health.
Results / Data
A public awareness campaign, called Get HIP, was created to visually communicate how to get, keep, and use the medical, vision, and dental benefits of HIP Plus.
Brochures for the Get HIP campaign, designed and produced by Rachel Knierman, Herron School of Design student. Covers are shown below.
