Sooner than anticipated, the state’s subsidized health insurance plan has reached the federal cap placed on the number of childless adults it can serve.

Although the Healthy Indiana Plan still has room for nearly 90,000 adults who have children in their homes, it has put about 6,000 "noncaretaker’’ adults on a waiting list for the program, which began in January 2008.

State officials did not anticipate that so many older and chronically ill people would apply for the program, which provides low-cost health insurance for lower-income adults.

“We were actually quite surprised,” said Jill Claypool, director of care programs for the Family and Social Services Administration. “We had envisioned that our target audience would be much younger.”

About 34,000 noncaretaker adults and 10,000 caretaker adults are enrolled in the plan.

Because the federal government provides matching funds for the program, which is also supported by the state’s cigarette tax, Indiana and the Centers for Medicare&Medicaid Services negotiated how it would work.

According to CMS policy, Medicaid demonstration projects such as HIP must be “budget-neutral,” which means they must cost the federal government no more than it would spend if the program did not exist.

“The cap of 34,000 in Indiana was a mutually agreed-upon number of ‘expansion eligible’ individuals,” CMS spokeswoman Mary Kahn wrote in an e-mail.

The state cannot change the cap without CMS’ permission.

Last month, Indiana asked to extend the limit. Washington said no.

The denial leaves people like Alice Moeloa with few options. The Logansport resident lives on disability payments and has not had insurance for years.

First, Moeloa applied for Medicaid, which provides dental and vision coverage, as well as medical insurance. Medicaid, though, would require her to give up much of her monthly disability check, and Moeloa feared she couldn’t live on the rest.

A few weeks ago, she filed an application for HIP. Her diabetes has caused seeping wounds in her legs, making it difficult for her to walk. Moeloa desperately wants insurance to visit a local wound clinic.

Because Moeloa, 57, is on disability, she can apply for Medicare in about a year and a half. But she does not want to wait.

“Every little itty bit scratch I get on my leg, I get infected,” she said.

Indiana has 157,816 people from the ages of 50 to 64 who do not have health insurance, said June Lyle, state director for AARP Indiana.

About one in six people at age 50 is denied coverage in the private market. At age 60, that number rises to one in four.

HIP “has made a dent, but when you look at the total number of uninsured in the state, there’s still a huge, unserved need,” Lyle said.

FSSA officials say they hope there will be a leveling off in applications from noncaretaker adults. The early rush from those with chronic diseases may represent a “pent-up demand,” Claypool said.

As people who have the benefit leave the program — for instance, when they become eligible for Medicare — the state will replace them with those now on the waiting list on a first-come, first-served basis.

The state is exploring whether it can offer those on the waiting list an option to buy into the plan at the state rate, Claypool said.

Many in need might not be able to partake, the AARP’s Lyle says.

“It’s doubtful that that’s going to solve the problem for the majority of people,” Lyle said. “This points to the need of tackling this at the federal level.”

Until federal health-care reform occurs, though, state officials will concentrate on attracting more adults with children to the plan. Claypool said it was unclear why more caretaker adults have not applied. The state is marketing the program to parents whose children are covered under Hoosier Healthwise to expand the number of caretaker adults in it.

The federal government also may have played a role in the state’s inability to draw more caretaker adults, said David Roos, executive director of Covering Kids&Families of Indiana, an advocacy group.

The state originally wanted the companies that offer the insurance to market it. But federal officials nixed that idea, placing the burden on the state to get out the word, Roos said.

Floods and other natural disasters, as well as administrative challenges such as modernizing the welfare eligibility program, took precedence, he added.

Despite the problems, the state deserves kudos, Roos said.

“It’s a healthy sign that Indiana was doing something,” he said. “We were grappling with the problem, and it’s not an easy problem.”