Indiana uses an HSA like account to encourage enrollees to behave more like consumers.  The Personal Wellness Responsibility (POWER) account is the centerpiece of the Indiana Check-up law, which goes into effect on January 1, 2008.  These are for individuals not eligible for Medicaid, but who earn up to $200 % of the Federal Poverty Level (FPL). Enrollees receive a $1,100 contribution to their account to be used for health care services and prescriptions.  Unused balances are rolled over at the end of the year. 

A key aspect of the reform is the design of the health plan that will be offered to the newly covered adults. Utilizing the Health Savings Account model combined with comprehensive insurance coverage above the deductible, individuals would annually receive $500 of pre-deductible, free preventive care and have a $1,100 deductible.

The deductible is paid for through a POWER (Personal Wellness Responsibility) Account established in the individual's name. The account will contain the monthly contributions made by participants in addition to a State contribution for a combined total of $1,100 per adult, which covers the cost of the deductible. The State's contribution will vary according to a sliding scale based on a participant's financial ability to contribute to the account. The State will subsidize the account to ensure there is a total of $1,100 per adult in the account. Participants will contribute no more than 5 percent of their gross family income, and will not have any cost-sharing once the deductible is met. At the end of the year, the balance of the POWER account will roll-over to reduce the following year's required contribution, if the participant has received their age-, gender- and disease-specific preventative services. If they have not received these services, only their own pro-rated contribution to the POWER account will roll-over but the State's contribution will be returned to the State. This design is intended to create an incentive for recipients to utilize services in a cost-conscious manner.

Qualifying Participants will pay for a portion of the POWER accounts on a sliding scale based on income. The state will contribute the rest of the funds necessary to establish accounts of $1,100 per adult. If the funds in the accounts are depleted within a year, the commercial plans will kick in to provide continued coverage.