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Several hundred "high risk" Hoosiers gathered in the Indianapolis Central Library to learn about the coming of Obamacare last night. As participants in Indiana's high risk pool, we were gathered to hear the Executive Director tell us what will happen when the ACA takes over.

Indiana Comprehensive Health Insurance Association (ICHIA) has been my lifeline to health care for the past decade. As a cancer survivor I was abruptly cast out of the individual health insurance system in 2002 when Mutual of Omaha abandoned their individual policy holders.

At the time that was legal because they were abandoning an entire class of policy holders, so it wasn't "personal". Right. A brief letter in the mail: "We made a business decision. You'll be insured for another 6 months. Best wishes!"

You can guess what happened next. Although I had been continuously insured my entire life, was eight years post-chemo and pronounced N.E.D. (no evidence of disease) by my doctors, I was completely and totally uninsurable on the open market.

Indiana's high risk pool was my only option and it's been my lifeline. Until now. Until Obamacare.


I was interested in hearing about ICHIA's transition plans. The presentation was excellent but during the Q & A I was reminded that I am still in Indiana, my beloved home state that collectively loses its mind from time to time.

There's a lot of misinformation out there and it was apparent in the audience. Whenever the words "federal program" or "government program" were uttered by the presenter there was a collective groan or derisive laughter from the audience.

That irritated the tweet out of me.

Looking around the room, I kept thinking ...

Hey! aren't we ALL beneficiaries of an excellent government program?

A PROGRESSIVE, forward thinking, government program?? Right now?


My experience with ICHIA over the years has been terrific. After hearing the Executive Director of this not-for-profit organization speak tonight I can understand why.

It hasn't been cheap. It was managed by Anthem and I have paid significantly more in premiums than I have received in benefits. But looking back with hindsight, I probably didn't fully appreciate what I have had. How could I have known? There was no transparency in the system until now.

ICHIA was established as a stand-alone non-profit organization by the State of Indiana 30+ years ago with a mandate to insure the uninsurable.

According to the Executive Director, Doug Stratton, ICHIA has been one of the most successful programs of its kind in the country. Out of 30+ state programs, we are one of only 2 state programs with no annual or life-time benefit caps. There are Hoosiers alive today who have individually received $15-18,000,000 in benefits through ICHIA.

I learned tonight that our premiums make up 50% of the annual operating costs, with the remaining 50% covered by the state (75%) and the insurance provider (Anthem 25%). There are 7300 Hoosiers covered by ICHIA, including 2200 children in the Ryan White program.

With that kind of progressive, forward thinking history ... how the hell did we get to the point that Mike Pence, our shiny new ruby-red Governor, decided that we would be one of the crazy states that opts out of the Medicaid expansion?


So what else did I learn that you would be interested in? For one thing, I'm delighted that Indiana has been cast into the federal Health Care Marketplace (formerly called exchanges). I simply don't trust my state government to do the right thing.

Secondly, I refer you to yesterday's diary by mdmslle: OH SNAP! The Smackdown Will Commence Shortly about the states that have refused the Medicaid expansion. After hearing what I heard last night, and listening to my fellow mis-informed Hoosiers I agree. The smackdown will commence shortly ...

Her are the key take-aways:

The ACA is a massive program and details are still being worked out.

They expect individual plans to be available in January 2014 but there is a contingency plan for ICHIA to continue if necessary.

There is only 1 criteria for participation in Obamacare: you must be a US citizen (yes, he really said that!).

There are only 3 criteria for underwriting: age, geographic location and whether or not you smoke. (Gender and pre-existing conditions are OUT)

NO MORE JUNK INSURANCE: The ACA mandates Essential Health Care Benefits as a baseline. You MAY choose add-on products, but no more junk.

No more exclusions or life-time caps.

Open enrollment will begin October 1, 2013. The Open enrollment period will extend through March 31, 2013.

If you have a "life event" (marriage, death, major move) the open enrollment period is extended.

There will be subsidies (actual pass-through to the insurance company) for low income (up to 400% of poverty level) and tax credits for those whose income is high enough to pay taxes.

You may choose to avoid the Federal Marketplace and purchase individual policies directly from commercial insurers. Commercial baseline policies must comply with the "Essential Health Care Benefits". However, none of the subsidies or tax credits will be available outside of the Federal Marketplace.

The main take-away: Be proactive! Do you homework! Read up on things!

Go to to get up-to-date info for your state.

Three types of "helpers" will be available at no charge to help you choose your plan: Navigators, Assistors and Certified Application Counselors. They are being trained now. If you have a good broker, talk to them now.

Overall? This is good government at work and I'm happy.

Originally posted to annan on Wed Jul 17, 2013 at 05:32 AM PDT.

Also republished by Indianapolis Kossacks.

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