The state agency overseeing Medicaid is hiring 400 employees to check the eligibility of the 560,000 low-income Hoosiers getting their health insurance through the Healthy Indiana Plan.
Fifty of those have been onboarded as state employees since the effort began last month, according to Family and Social Services Administration spokesman Marcus Barlow.
The hiring spree comes as FSSA prepares to comply with new state and federal work requirements, including more frequent eligibility checks.
State lawmakers voted to implement work requirements for Healthy Indiana Plan members starting on July 1, 2025 but were overridden by Congress. Federal work requirements for participants in Medicaid expansion programs nationwide take effect Jan. 1, 2027.
“Twenty years ago, Indiana created the Healthy Indiana Plan … to provide coverage for the uninsured, low-income working Hoosiers, the working poor — emphasis on the word ‘working,'” FSSA Secretary Mitch Roob said Tuesday, during a quarterly financial reporting meeting.
Healthy Indiana Plan enrollees will have to spend at least 80 hours each month working, participating in a work program, attending school or volunteering.
“Our responsibility message is simple. We will meet you with assistance, but you must meet us with effort,” Roob told attendees, in a speech that heavily emphasized personal responsibility.
“This is not your doctor’s job, to keep you eligible. It is not the hospital’s job. It is not the health plan’s job to keep you eligible. It is not even FSSA’s job to keep you eligible,” Roob added. “It is the recipient’s responsibility. It is their personal responsibility.”
There are exceptions to the work requirements for pregnant mothers, caregivers of young and disabled dependents, people under 19 or above 64, the medically frail and more.
State and federal law will also begin requiring more frequent eligibility checks.
“According to (Indiana) Senate Enrolled Act 1, we will have to check compliance with the Medicaid work requirements at least quarterly, so that will increase the number of checks two times,” said Division of Family Resources Director Sunshine Beam. “Then, on top of that, (the federal) H.R. 1 changed the redetermination for individuals on HIP to six months.”
Plan members will undergo “at least” three times more checks than they do now, Beam said.
FSSA’s spending on postage has already driven overspending in its eligibility determination services system, according to the Tuesday presentation. Those costs are expected to increase by at least 1.5 times as the number of required checks increases, Beam said.
The agency isn’t expecting to save any money on ineligible Hoosiers who are kicked off the plan.
That’s because the federal government covers 90% of the costs for Medicaid expansion populations and the state uses Hospital Assessment Fee revenue to handle the other 10%, Roob told the Indiana Capital Chronicle. There’s no General Fund impact.
“We will not save any money,” he said. “The goal here … was, frankly, never for the state of Indiana to save money.”
Food, childcare updates
H.R. 1, also known as the One Big Beautiful Bill Act, additionally makes major changes to the Supplemental Nutrition Assistance Program, the nation’s largest anti-hunger initiative.
States currently pay 50% of the cost to administer SNAP, but beginning Oct. 1, 2026, they’ll be on the hook for 75%.
That’s expected to cost Indiana $37 million in the 2027 state fiscal year, which begins July 1 and ends June 30, and about $50 million annually after, according to FSSA.
Starting Oct. 1, 2027, states will also pay a percentage of the benefits themselves depending on the rate of errors they make in distributing the funds — overpayments and underpayments. Indiana logged a 9.27% payment error rate in the 2024 federal fiscal year, per the report. That runs from Oct. 1 to Sept. 30.
The state’s 2025 error rate is preliminarily between 6% and 7%, Beam said, but that hasn’t been validated yet. Official SNAP error rates for the previous federal fiscal year are released in June, according to Barlow.
Officials also revealed the completion of more than 1,700 compliance checks on regulated childcare facilities prior to their $200 million funding request for a frozen childcare assistance program.
The Child Care and Development Fund is a state-administered federal program that serves about 40,000 children in Indiana as of March, according to Tuesday’s presentation. Families must meet income and work requirements to qualify for the assistance.
The agency found “0 instances of fraud that required referral for prosecution” during its unannounced visits to the facilities, Barlow said. Investigators checked that the facilities were open with children present.
“The worst thing that could have happened to childcare in Indiana would have been to inject $200 million of additional taxpayer money into the program and discover that there was fraud going on, as in Minnesota,” Roob said, referring to a wide-ranging human services fraud scandal there.
“So we satisfied ourselves and satisfied the governor and the Legislature that there’s not fraud going on in this program — candidly, unlike several of our other FSSA programs,” he added. “So we’re pleased with that, and this was a prerequisite of our (funding) recommendation.”
The State Budget Committee approved the request at a meeting this month.
FSSA projects the funding will allow it to bring 14,000 children off a waitlist that has grown to nearly 37,000 as of March. That would bring enrollment back up to 57,000 children.
Barlow said there was no cost to the compliance checks “as they were done internally with FSSA’s Investigations team in the normal scope of business.”
Indiana Capital Chronicle is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Indiana Capital Chronicle maintains editorial independence. Contact Editor Niki Kelly for questions: info@indianacapitalchronicle.com.
