Gov. Braun defends Medicaid strategy following ABA cuts

By TIM SPEARS
WISH-TV | wishtv.com

Gov. Mike Braun is defending his strategy to reduce Medicaid spending after the state cut coverage of a popular autism therapy.

On Wednesday, Gov. Braun signed an executive order creating a task force to evaluate applied behavior analysis, or ABA therapy. It’s a method of focusing on behavior to help people with autism improve communication, development, and socialization.

The task force will evaluate best practices for ABA therapy under Medicaid, which the state says more than 8,000 Hoosier children with autism rely on, then submit a report to Gov. Braun by November.

As News 8 reported, the Braun administration has already placed a three-year limit on ABA coverage under Medicaid, with some exceptions, and placed weekly limits on therapy hours. The coverage caps are expected to start in April, pending federal approval.

“We have to do all we can to control rising costs,” Braun said.

The Braun administration’s larger Medicaid crackdown started with increasing the number of eligibility checks, from once a year to once a quarter, and ordering providers to stop advertising Medicaid programs on TV and radio.

Senate Minority Leader Shelli Yoder, D-Bloomington, described the advertising ban as “making sure that Hoosiers don’t know what they’re eligible to receive.”

Yoder said, “We have so many nonprofit agencies across the state that provide that guidance and help to Hoosiers and now they’re left wondering, ‘is that going to be prohibitive, can we not help the clients that we serve?’”

Braun pushed back against questions from News 8 whether he’s attempting to lower Medicaid enrollment by limiting access and making programs more difficult to navigate.

Braun claims he’s trying to get in front of Medicaid “going broke.”

“At some point it’s got to be reformed,” Braun said.

The next major Medicaid battle is Senate Bill 2, which would add work requirements for the Healthy Indiana Plan (HIP) and cap HIP enrollment to 500,000. The cap would effectively cost about 200,000 current Medicaid enrollees their coverage.

The bill passed the Senate on a party-line vote of 40-9. The bill now goes to the House.

Yoder believes the proposed cap on HIP enrollment and ABA therapy seems to lack any relationship to the current demand for healthcare.

“We are making these sweeping changes based on arbitrary numbers, gut feelings,” Yoder said. “We don’t have the information or analysis to go boldly into these changes.”

FSSA Secretary Mitch Roob said the three-year limit on ABA coverage could be lifted before patients hit the 36-month cap in April 2028.

“I’m not making any guarantees,” Braun said. “I want to make sure we get it under control and can do it sustainably.”

Indiana faced a $1 billion Medicaid budget shortfall last year. An audit found at least $56.5 million in improper Indiana Medicaid payments for ABA services over the course of a year. There are nearly two million Hoosiers enrolled in some form of Medicaid, but Roob told News 8 the state does not have a target enrollment number it’s trying to reach.

Any material changes to Medicaid are subject to federal approval.

This story was originally published by WISH-TV at wishtv.com/news/i-team-8/braun-defends-medicaid-strategy-following-aba-cuts.