Indiana is the latest solidly-red state to work out a compromise with the Obama administration to expand Medicaid.
An additional 350,000 people should get health coverage under the compromise program that Republican Gov. Mike Pence announced on Tuesday.
Beginning in February, that state will offer an updated version of its "Healthy Indiana Plan" (HIP) to anyone with an income at or below 133 percent of the federal poverty line. There are two versions of HIP -- HIP Basic and HIP Plus, which provides vision and dental benefits in addition to basic health care coverage.
Any Indiana resident at or above 100 percent of the poverty line must join HIP Plus by making relatively small premium payments (no more than 2 percent of their income). Residents below 100 percent of the poverty line may also join HIP Plus by making small premium payments.
Typically, Medicaid recipients do not need to make premium payments, but the Obama administration agreed to this modification in order to get the Republican state on board with an expansion of the program.
"Since the beginning of my administration, we have worked hard to ensure that low-income Hoosiers have access to a health care plan that empowers them to take charge of their health and prepares them to move to private insurance as they improve their lives," Pence said in a statement. "This has been a long process, but real reform takes work."
When the Affordable Care Act passed in 2010, it required all states to expand Medicaid to make it available for all low-income citizens. Previously, only certain low-income people like the elderly and children were eligible for the program.
However, in 2012, the Supreme Court ruled that the expansion should be optional. The Obama administration has made the program cost-free initially for the states -- the federal government covers 100 percent of the cost through 2016 and will pay for at least 90 percent after that -- but only 29 states (including Indiana and Washington, D.C.) have signed up.
The administration has made a point of working with Republican state lawmakers on compromise versions of the program to make it more palatable to conservatives. "I want to see all 50 states expand in ways that work for their states," Health and Human Services Secretary Sylvia Burwell said in a speech at a Washington, D.C. health conference last week. She noted that other red states like Wyoming and Alaska are also searching for ways to expand the program.
While not every state has signed on, the expanded version of Medicaid has gone a long way in expanding health coverage in the U.S. -- more than 9.7 million Americans have gained coverage through Medicaid or the Children's Health Insurance Program (CHIP) since October 2013.
Meanwhile, millions of Americans are getting coverage this year through the Obamacare marketplaces. Burwell noted in her speech that more than 7.1 million consumers have enrolled for 2015 coverage through HealthCare.gov, the federal Obamacare website. The nationwide number of Obamacare enrollees will be higher once consumers in state-run Obamacare marketplaces are tallied.
On Thursday, several organizations are holding health care fairs across the country to encourage young adults to enroll in health coverage. Data from last year shows that 52 percent of young adults who signed up for Obamacare waited until the last month of the open enrollment period to do so. Open enrollment for this year continues through February 15.