INDIANAPOLIS — Pent-up demand for affordable health care has produced 21,101 applications for a new state health plan for low-income adults, but key lawmakers said the state must find ways to cover people not currently eligible.

Secretary Mitch Roob of the Family and Social Services Administration told a joint meeting of the state Senate and House health committees that his agency has had to more than double the staff of the Healthy Indiana Plan because of the volume of applications.

“We're thrilled with the number of people who've applied, and the breadth,” Roob said, noting the plan has drawn applications from each of the state's 92 counties.

Lawmakers commended Roob on his agency's efforts in putting the plan in place and winning federal approval since the General Assembly approved it last spring.

However, they criticized the plan's restrictions that bar enrollment, for instance, to anyone eligible for an employer-covered health plan and to anyone whose household earns more than twice the federal poverty level, a sliding scale that recently rose to $20,800 for an individual or $42,400 for a family of four.

Sen. Pat Miller, the Indianapolis Republican who chairs the Senate health panel, urged Roob and Gov. Daniels' administration to work on an expansion that would cover more Indiana residents. She said some people earning barely above the income limits need help, too.

Sen. Vaneta Becker, R-Evansville, read a letter that a constituent had sent Daniels complaining that she was ineligible because her employer offered health insurance that she could not afford. The woman, who works at an Evansville casino, earns just $8 per hour, well within the income limits of the state plan.

Roob said the Daniels administration was exploring additional ways to provide health insurance.

“This is the first step on a long road,” Roob said. “It is a very difficult issue to navigate.”

The state has estimated more than 550,000 people might qualify for the Healthy Indiana Plan. The program will cost the state an estimated $190 million per year, most of that coming from a 44-cent-per-pack increase in the cigarette tax. The state is using those funds to leverage about $1.1 billion in federal Medicaid funding over five years.

Because the state is using Medicaid funds, it needed to win approval from the Centers for Medicaid and Medicare Services, and the federal agency ordered changes in the plan, Roob said.

For example, CMS ordered the state to allow non-U.S. citizens who are legal aliens to enroll and made demands that forced the state to remove dental and vision coverage from its plan, Roob said.

It also said the plan could enroll no more than 34,000 childless adults among the 130,000 people the state can afford to enroll this year. Roob said that group represents about 70 percent of the approved enrollees so far, rather than the maximum of 26 percent required by CMS. Roob said he expects the percentage to drop.

While the state took 21,101 applications between mid-December and Wednesday, it has processed only 6,198, Roob said. FSSA is meeting the CMS requirement that applications get processed within 45 days, he said.

Of those processed, FSSA has rejected about a fifth for a variety of reasons, including exceeding income limits or eligibility for employer-sponsored plans, Roob said.

Another 3,392 applications, or more than half of those processed, remain pending approval, and Roob said he expects many of those came from applicants with children, since the state requires more paperwork from them.

Only 295 of the applicants have received full approval, and 1,299 others have conditional approval.

FSSA has hired 46 additional people to staff the health plan, , Roob said. The agency expected to enroll only 50,000 people this year.

The plan is available to uninsured adults ages 19-64 who generally join one of two plans provided by insurers MDwise and Anthem Blue Cross and Blue Shield. Both plans provide enrollees:

♦ Up to $500 a year in free preventive health care such as smoking cessation, mammograms, prostate exams and flu shots.

♦ A health savings account worth $1,100 a year, with contributions by the state, the enrollee and willing employers. Individual contributions vary from 2 percent to 5 percent of gross household income, and employers can pay up to half of that share.

♦ For medical costs exceeding $1,100, benefits of at least $300,000 annually.