Indiana Gov. Mike Pence asked the federal government Wednesday to approve a three-year extension of the Healthy Indiana Plan health savings accounts in lieu of an expansion of a federal Medicaid system he called "broken." Pence wrote a letter to Health and Human Services Secretary Kathleen Sebelius, saying Medicaid is broken, with a history of substantial waste, fraud and abuse and it has failed to keep pace with private market innovations that have created efficiencies, controlled costs and improved quality. The Indiana Family and Social Services Administration requested a waiver from the Centers for Medicare and Medicaid Services, — a move that would effectively cover roughly 400,000 residents through health savings accounts instead of traditional Medicaid. An HHS spokesman said he was reviewing Pence's letter and waiver request. The cost to the state of expanding through the HIP program is still unknown.