The Washington Post reports on conservative Indiana’s approach to the expansion of Medicaid enabled by Obamacare.

Indiana requires fees from even the poorest people to obtain vision and dental coverage as well as regular health care. In Indiana, the requirement is payment to a health savings account, as little as $1 a month. If participants don’t make payments, they lose the enhanced coverage and also are assessed co-payments.

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Writes the Post:

Yet Healthy Indiana remains a singular experiment with an uncertain outcome. Detractors worry that its complexity could make health care harder for the poor to access — the opposite of a core goal of expansion. There is no proof that the state is saving money or that its approach is making participants healthier.

“Other states have looked at it, but the Obama administration has made it pretty clear that Indiana is going to be a test case and much evaluation will need to be done before they approve any more like it,” said Matt Salo, executive director of the National Association of Medicaid Directors. No other program has been allowed to require health spending accounts, much less threaten to yank coverage for a person not paying in, he noted.

Arkansas’s Republican Gov. Asa Hutchinson,  has met some resistance from federal officials on some of his ideas for his reworked version of Obaamcare in Arkansas, the so-called private option. He wants to rename it “Arkansas Works” as a PR strategy. His plan calls for insurance premiums and co-pays, but no punishment for those who fail to pay. His plan also calls for referrals to job training programs.

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The Post article finds a mix of opinions on how Indiana’s program is working. It, like Arkansas, has added a huge number of people to the roll of the insured. But some have been dropped, too, and conservatives note there, as in Arkansas, that the Medicaid expansion comes at an increased cost to federal taxpayers.

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