State Exchange Profiles: Indiana

Final update made on December 13, 2012 (no further updates will be made) 

Establishing the Exchange

In November 2012, Governor-elect Mike Pence (R) announced that he would not move forward with setting up a state-based health insurance exchange when he takes office in 2013.¹

During his term, Governor Mitch Daniels (R) had signed Executive Order #11-01 in 2011 to conditionally establish and operate the Indiana Insurance Market, Inc., a nonprofit corporation to serve as the Indiana health insurance exchange.² The Executive Order defined Indiana’s exchange as a nonprofit incorporated by the Secretary of the Indiana Family and Social Services Administration, working with the Indiana Department of Insurance. An interagency group including, the Department of Insurance, the Family and Social Services Administration, and the Office of Medicaid Policy and Planning, worked on exchange planning in the state. However, since issuing the Executive Order, Indiana began to move away from a state-based exchange.³ While the state had assembled two pieces of draft exchange legislation, the Department of Insurance did not propose either during the 2012 legislative session, which ended in March 2012.⁴

On May 5, 2011, Governor Daniels signed HB 1210, which prohibits qualified health plans purchased through an exchange in Indiana from covering abortions, except in the case of rape, incest, or to avert impairment or death of the pregnant woman.⁵

Essential Health Benefits (EHB): The ACA requires that all non-grandfathered individual and small-group plans sold in a state, including those offered through the Exchange, cover certain defined health benefits. Since Indiana has not put forward a recommendation, the state’s benchmark EHB plan will default to the largest small-group plan in the state, Anthem Blue Cross Blue Shield of Alaska- Blue Access PPO.

Exchange Funding

In May 2011, Indiana was among the first three states to be awarded a federal Level One Establishment grant.⁶ The Indiana Department of Insurance and Family and Social Services Administration received of $6.9 million to update their information technology systems, develop a financial management plan, and acquire legal, actuarial, and financial expertise.⁷ The Indiana Family and Social Services Administration also received a federal Exchange Planning grant of $1 million in September 2010.

Next Steps

The federal government will assume full responsibility for running a health insurance exchange in Indiana beginning in 2014.

Additional resources related to Indiana’s exchange planning can be found at:http://www.nationalhealthcare.in.gov

1. Gov-Elect Pence: Indiana Should Not Establish State-based health insurance exchange. November 15, 2012. http://www.mikepence.com/exchange
2. Indiana Executive Order #11-01. January 2, 2011.http://www.in.gov/gov/files/Executive%20orders/EO_11-01.pdf
3. State of Indiana Letter to CMS. Comment on State Exchange Plan Application. January 10, 2012. http://www.in.gov/aca/files/Indiana_Exchange_Certification_Application_Comments.pdf
4. Level One Establishment Grant Quarter 1 Report. 10/30/2011.http://www.in.gov/aca/files/HIX_Level_One_Quarterly_Report.pdf
5. HB 1210 (Chapter 33). Indiana’s 2011 act related to Health Care Exchanges and Abortion.http://www.in.gov/legislative/bills/2011/HE/HE1210.1.html
6. Indiana Health Insurance Exchange Level One Funding Solicitation.http://www.statecoverage.org/files/IN_InsuranceMarketGrantITGAPSummary_2011.pdf
7. HealthCare.gov. “Creating a New Competitive Marketplace: Affordable Insurance Exchange Establishment Grant Awards List.” August 12, 2011.http://www.healthcare.gov/news/factsheets/exchanges05232011a.html