Braun Defends Medicaid Strategy

Indianapolis (WISH) - Gov. Mike Braun is defending his strategy to reduce Medicaid spending, which includes limiting coverage of applied behavior analysis (ABA) therapy for autism treatment. The state has already placed a 3-year limit on ABA coverage under Medicaid, with some exceptions, and weekly limits on therapy hours.

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

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

The Braun administration's larger Medicaid crackdown includes increasing 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."

"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 whether he's attempting to lower Medicaid enrollment by limiting access and making programs more difficult to navigate.

"At some point it's got to be reformed," Braun said.

The state faces a $1 billion Medicaid budget shortfall, and an audit found at least $56.5 million in improper Indiana Medicaid payments for ABA services over the course of a year. The state does not have a target enrollment number it's trying to reach.

Braun believes his strategy is necessary to control rising costs, saying "I want to make sure we get it under control and can do it sustainably." 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.

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.