COLUMN: Medicaid reform is about protecting the promise we made to Hoosiers
Medicaid is an important commitment our state makes to Hoosiers. It provides healthcare for children, seniors in long-term care, people with disabilities and Hoosiers facing hard financial circumstances. For many, it's a lifeline that offers stability when life throws curveballs.
Protecting that commitment means keeping Medicaid financially sustainable for the people it was meant to serve, for years to come.
Before the COVID-19 pandemic, Indiana's Medicaid program covered about 1.5 million Hoosiers, as of February 2020. During the global pandemic, federal rules restricted states from removing anyone from the program, even if their circumstances changed. As a result, enrollment climbed, peaking at 2.3 million in April 2023.
Those temporary policies served a purpose. They helped families keep access to care when jobs were lost, incomes fluctuated and uncertainty was at an all-time high. But emergency policies were never meant to become permanent.
When the continuous-enrollment requirement ended, the state spent a year reviewing every case to determine who still qualified. About 371,000 Hoosiers were disenrolled, but 20% to 25% re-enrolled within 90 days of providing the necessary information the state required. That shows part of the problem, that eligible Hoosiers were being disenrolled because of paperwork and outdated verification systems, not because they no longer qualified. That's not fiscal responsibility, that's a program not running as intended.
As the pandemic ended, Indiana faced an important question: How do we preserve Medicaid for those who truly need it while also being fiscally responsible with taxpayer dollars?
The answer is not eliminating Medicaid or reducing care for vulnerable Hoosiers. The answer is making sure that the program works the way it was designed to.
That's why the General Assembly has taken steps in recent years to strengthen Medicaid's long-term future. In 2025, Senate Enrolled Act 2, a law I supported, improved eligibility verification and program-integrity measures to ensure that benefits go to people who qualify. That work continued during the 2026 legislative session, when Senate Enrolled Act 1 strengthened oversight to put Medicaid on a more sustainable path for years to come.
These reforms are rooted in the idea that public resources should be focused on where they're needed the most. As a conservative Republican, I believe in limited government and compassionate conservatism. Government has a role to play in providing resources to those who truly need it.
Every dollar spent on someone who is no longer eligible is a dollar unavailable for a child with medical needs, an aging senior or a person living with a disability.
Indiana has a track record demonstrating that fiscal responsibility and compassion can work together. We've balanced budgets, maintained healthy reserves and invested in priorities that strengthen our communities. Applying the same process to Medicaid helps ensure the program remains strong for future generations.
No one hopes to need Medicaid, but Hoosiers should know that the program will be there as a safety net. But this requires thoughtful policymaking, oversight and the willingness to adapt when temporary policies no longer fit.
By restoring Medicaid to its intended purpose, Indiana is protecting a vital program for the people who rely on it most. As a member of the House Public Committee, I remain committed to working with my fellow legislators to make sure Medicaid stays strong, sustainable and true to the promise that we made to Hoosiers.
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State Rep. Tony Isa (R-Angola) represents House District 51,
which includes all of LaGrange County and a portion of Steuben County.
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