A bill limiting health insurance for Hoosiers passed out of the Senate, which means it needs House approval before hitting Gov. Mike Braun’s desk.

Sen. Ryan Mishler, R-Mishawaka, authored Senate Bill 2 which would place restrictions on Medicaid, like work requirements on an insurance program for Hoosiers with a median income and between the ages of 19 to 64.

The bill also creates a program cap, which threatens access for hundreds of thousands of Hoosiers.

Mishler said Tuesday the bill includes 11 exemptions for the work requirement, including volunteering, receiving unemployment or participating in a substance abuse program.

“This bill is just the start. Medicaid is a big issue,” Mishler said.

The bill passed out of the Senate 40-9.

He called Senate Bill 2 the “right size” for Medicaid, which has grown exponentially in recent years. In the last four years, Medicaid costs have grown by $5 billion, he said.

“We’re spending more on Medicaid alone than the percentage of our total revenue,” Mishler said. “You’re going to see that when we do the budget that Medicaid and the Department of Child Services are going to suck up most of our revenue and we’re not going to have a lot left to do other programs.”

The enrollment in the Healthy Indiana Plan has nearly doubled from 390,000 pre-COVID to more than 750,000 in January.

HIP, which was started in 2008, covers individuals with an annual income of $20,793; couples with an annual income of $28,214.40; and a family of four with an annual income of $43,056.

Sen. Fady Qaddoura, D-Indianapolis, said the legislators have to reckon with maintaining Medicaid services amid the inaccurate projection by $984 million for its Medicaid expenditure forecast in April 2023. The missed projection was the result of state reversions and unanticipated growth of services for aging and disabled residents.

The bill would end the expansion of Medicaid in Indiana. The bill would take the state back to the initial version of the Healthy Indiana Plan, where through a waiver the state controls who is added to the plan, Qaddoura said.

“We’re effectively killing Medicaid expansion in the state of Indiana under the federal law,” Qaddoura said.

Mishler said the waiver gives the state rather than the federal government control over health care.

“I don’t care who’s in charge in Washington but I would rather be in charge of our health care plan than the federal government,” Mishler said.

Qaddoura said he’s concerned that the legislature is making an assumption that 300,000 people joined Medicaid because they could and not because they need the services.

“My question is where is the data showing that 300,000 people do not need Medicaid services?” Qaddoura said. “To be on the safer side, instead of pushing 300,000 people out of the program, I would be much more comfortable going through the details of the program to know who deserves, based on health conditions and financial status, to stay in the program versus those who might not need the program.”

Sen. Shelli Yoder, D-Bloomington, said Senate Bill 2 is “doubling down” on the idea that Medicaid recipients are “gaming the system.” But federal audits found that improper Medicaid payments were the result of administrative errors, she said.

“It’s not people stealing money,” Yoder said. “Instead of fixing the administrative system, Senate Bill 2 chooses to actually punish patients.”

The bill would also make it illegal to advertise Medicaid, Yoder said.

“We are actively choosing to keep people in the dark about healthcare that they qualify for,” Yoder said.

The bill now moves forward to the House.

akukulka@post-trib.com