Indiana Medicaid Chief Warns of Hospital Fee Phase-Down Fallout
At a quarterly financial meeting, Indiana Family and Social Services Administration Secretary Mitch Roob warned that a federally mandated phase-down of the state's hospital assessment fee will create a "material" budget hit for the Healthy Indiana Plan. Under the One Big Beautiful Bill Act, the fee drops from 6% to 3.5% by late 2031, a change Roob said could have cost the state roughly $900 million, or 40% of collections, had it applied last fiscal year. Roob presented early projections from consultant Deloitte, with a fuller Medicaid forecast due to lawmakers in December, and said the state must find cheaper care delivery models rather than simply cutting rates or eligibility to avoid a "catastrophic situation" by 2032. The fee currently funds the state's share of costs for HIP, which covers expansion adults, pregnant women and low-income caretakers.