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Indiana Medicaid Director Cora Steinmetz will resign in early 2025 after navigating the Office of Medicaid Policy and Planning through a forecast variance that resulted in cost containment strategies, new robust monthly financial reporting, and a more thorough policy review process.

“Few individuals have made such a remarkable impact on an agency in such a short time," FSSA Secretary Dr. Dan Rusyniak said. "Her leadership came at a pivotal moment, and Indiana was incredibly fortunate to have her at the helm of Medicaid. She guided us through unprecedented challenges with vision and determination, leaving our agency stronger, more resilient, and ready for the future.”

Steinmetz has been Medicaid director since August 2023. Previously, she worked as Gov. Eric J. Holcomb’s senior operations director for health-related state agencies, including the Family and Social Services Administration, Department of Child Services and Indiana Department of Health.

Indiana Medicaid faced an unprecedented $1 billion forecast variance in late 2023, and Steinmetz led the office in establishing a number of review and reporting practices to enhance oversight of the Medicaid budget, address the variance and ensure such a variance does not happen again, including:

Implementation of improved financial forecasting and trend analysis, including the use of more real-time data.
Monthly reporting processes to analyze trends and ensure transparency and stewardship of taxpayer resources.
Development of agency-wide processes to review programmatic changes to ensure an understanding of enrollment, utilization, and reimbursement impacts.

Additionally, under her leadership, Indiana Medicaid has:

Launched the Indiana PathWays for Aging program, a managed Long-Term Services and Supports (mLTSS) program and the state’s fourth managed Medicaid program. Indiana PathWays for Aging provides coverage for 120,000 Hoosiers, 80% of whom are dually eligible for Medicare and Medicaid.
Transitioned the former Aged and Disabled waiver into two new waivers, the Indiana PathWays for Aging waiver for individuals aged 60 and older to coordinate waiver services with health coverage under the managed care program, and the Health and Wellness waiver for individuals under age 60 to improve alignment with other waivers supporting individuals with disabilities.
Submitted a five-year extension of the Substance Use Disorder (SUD) and Serious Mental Illness (SMI) 1115 waiver to ensure continued access to a comprehensive continuum of behavioral health services for Indiana Medicaid members.

“Leading Indiana Medicaid during this time has been a rewarding and challenging experience," said Steinmetz. "I am grateful for the opportunity to have contributed to meaningful progress while serving alongside a passionate and purpose-driven team.”

Steinmetz, a licensed attorney, has also worked as a program director for government programs and revenue cycle compliance for IU Health and was an attorney for the Indiana Department of Revenue and the Bureau of Motor Vehicles. She is also a board member for Music for All, a national organization focused on music education.

She is exploring options for future employment.

The U.S. population grew by nearly 1.0% between 2023 and 2024, according to the new Vintage 2024 population estimates released today by the U.S. Census Bureau.

As the nation’s population surpasses 340 million, this is the fastest annual population growth the nation has seen since 2001 — a notable increase from the record low growth rate of 0.2% in 2021. The growth was primarily driven by rising net international migration.

Net international migration, which refers to any change of residence across U.S. borders (the 50 states and the District of Columbia), was the critical demographic component of change driving growth in the resident population. With a net increase of 2.8 million people, it accounted for 84% of the nation’s 3.3 million increase in population between 2023 and 2024. This reflects a continued trend of rising international migration, with a net increase of 1.7 million in 2022 and 2.3 million in 2023.

"Improved integration of federal data sources on immigration has enhanced our estimates methodology," said Christine Hartley, assistant division chief for Estimates and Projections. "With this update, we can better understand how the recent increase in international migration is impacting the country's overall population growth." (More information on the Census Bureau’s updates to how it measures international migration are available in Census Bureau Improves Methodology to Better Capture Increase in Net International Migration).

Natural increase also contributed to the population growth, as births outnumbered deaths by nearly 519,000 between 2023 and 2024. This marks an increase from the historic low in 2021 when natural increase was just over 146,000, but it was still well below the highs in prior decades.

“An annual growth rate of 1.0% is higher than what we’ve seen over recent years but well within historical norms,” said Kristie Wilder, a demographer in the Census Bureau’s Population Division. “What stands out is the diminishing role of natural increase over the last five years, as net international migration has become the primary driver of the nation’s growth.”

Meanwhile, the voting-age resident population (age 18 and over) grew to nearly 267 million, representing 78.5% of the population and the number of U.S. children (ages 0 to 17) declined by 0.2% from 73.3 million in 2023 to 73.1 million in 2024.

The South Remains Fastest-Growing Region

At nearly 132.7 million residents, the South is the most populous region. With a population gain of nearly 1.8 million — a change of 1.4% between 2023 and 2024 — the South added more people than all other regions combined, making it both the fastest-growing and largest-gaining region in the country.

The largest contributing component to this growth was international migration, which added 1.1 million people. Domestic migration netted another 411,004 residents. The South was the only region with positive net domestic migration, where the number of people entering the region exceeded those leaving. Natural increase also contributed 218,567 to the growing region.

Within the South, Texas (562,941) and Florida (467,347) had the largest numeric gains, and the District of Columbia grew the fastest (2.2%) from 2023 to 2024.

The population in the West grew by almost 688,000 (0.9%) to a total of 80,015,776 residents. This growth was consistent with the national trend and continued despite a net domestic migration loss of almost 170,000, offset by a gain of 667,794 from net international migration. There was a gain of 187,986 from natural increase. In the West, California (232,570) and Arizona (109,357) had the largest numeric gains between 2023 and 2024, while Utah (1.8%) and Nevada (1.7%) grew the fastest.

Just over 57.8 million people lived in the Northeast between 2023 and 2024. During that time, the number of residents increased by 0.76% — a gain of almost 435,000.

Growth in the Northeast largely stemmed from net international migration (567,420). The number of people moving from the Northeast to other parts of the country continued to slow as the region lost fewer residents via net domestic outmigration (192,109) in 2024 than in 2023 (278,245).

Within the Northeast, New York (129,881) had the largest numeric gains, and New Jersey (1.3%) had the fastest-growing population.

The population in the Midwest increased by over 410,000 (0.6%) to a total population of 69,596,584 in 2024.

The region had a net domestic migration loss of 49,214, far fewer than the net domestic outmigration of 89,787 in the previous year. The Midwest gained 406,737 people through net international migration and experienced a net gain of 52,741 from natural increase.

Within the region, Illinois (67,899) and Ohio (59,270) had the largest population gains, while North Dakota (1.0%) and Iowa (0.7%) were the fastest-growing states.

Population Increased in Most States

Between 2023 and 2024, the population increased in 47 states and the District of Columbia, with nine states (Arizona, California, Florida, Georgia, New Jersey, New York, North Carolina, Texas and Washington) experiencing population gains of over 100,000 people. The District of Columbia was the fastest growing (2.2%) among state and state equivalents for the first time since 2011.

Texas, the second-most populous state, had the largest numeric increase in the country, adding nearly 563,000 people for a total population of 31,290,831 in 2024.

North Carolina’s population surpassed 11 million (11,046,024) and Florida’s population now exceeds 23 million (23,372,215), as both states experienced growth well above the national average at 1.5% and 2.0%, respectively.

Three states saw their populations decrease slightly between 2023 and 2024: Vermont (-215), Mississippi (-127) and West Virginia (-516), up from two states that lost population between 2022 and 2023.

The losses in Mississippi and Vermont resulted from negative net domestic migration and natural decrease (more deaths than births), and the loss in West Virginia was from natural decrease.

Migration Drives State Growth

Births outnumbered deaths (natural increase) in 33 states and the District of Columbia, with natural increase highest in Texas (158,753), California (110,466) and New York (43,701).

Seventeen states experienced more deaths than births, down from 19 states in 2023 and 25 states in 2022. Pennsylvania (-9,311), West Virginia (-7,844) and Florida (-7,321) were the states with the highest levels of natural decrease.

Texas (85,267), North Carolina (82,288) and South Carolina (68,043) saw the largest gains from domestic migration, while California (-239,575), New York ( -120,917) and Illinois (-56,235) experienced the largest net domestic migration losses between 2023 and 2024.

Net international migration was positive for all 50 states and the District of Columbia.

Florida (411,322), California (361,057) and Texas (319,569) saw the largest gains from international migration.

Refer to the bottom of the release for tables on the Top 10 Most Populous States: 2024, Top 10 States by Numeric Growth: 2023 to 2024, and Top 10 States or State Equivalent by Percent Growth: 2023 to 2024.

Population Decline in Puerto Rico Slows

Puerto Rico had a population of 3,203,295 in 2024 — a 0.02% decline over the prior year.

Though Puerto Rico’s population declined, it did so at a much slower pace than in recent years, having experienced drops of 1.3% and 0.5% in 2022 and 2023, respectively.

The U.S. territory did experience positive net migration (15,204), although this gain was offset by natural decrease, as there were far fewer births (18,219) than deaths (33,920).

Methodology

For the Vintage 2024 population estimates, administrative data were used to adjust the net international migration estimates. Details on this adjustment are available in the Random Samplings blog, Census Bureau Improves Methodology to Better Capture Increase in Net International Migration.

In March, the Census Bureau is scheduled to release estimates of the July 1, 2024, population and demographic components of population change for metropolitan and micropolitan statistical areas and counties, and Puerto Rico municipio population estimates. The data will be embargoed. The full release schedule for the Population Estimates Program can be found on the Census Bureau’s website.

With each new release of annual estimates, the entire time series of estimates is revised for all years back to the date of the last census. All previously published estimates (i.e., old vintages) are superseded and archived on the FTP2 site. Due to periodic methodological updates, such as this year’s immigration adjustment, year-to-year comparisons in the estimates should only be done within the same vintage.

To compare U.S. national and state population and demographic components of population change with those of other countries, explore the International Database (IDB). The IDB consists of estimates and projections of demographic indicators, including population size and growth, and components of change like mortality, fertility and net international migration for more than 220 countries and areas. This information, along with interactive maps and subnational data, is available on the International Database: World Population Estimates and Projections page.

**Top 10 Most Populous States: 2024**
Rank	Geographic Area	April 1, 2020 (Estimates Base)	July 1, 2023	July 1, 2024
Source: U.S. Census Bureau, Vintage 2024 Population Estimates.
1	California	39,555,674	39,198,693	39,431,263
2	Texas	29,149,458	30,727,890	31,290,831
3	Florida	21,538,192	22,904,868	23,372,215
4	New York	20,203,772	19,737,367	19,867,248
5	Pennsylvania	13,002,909	13,017,721	13,078,751
6	Illinois	12,821,814	12,642,259	12,710,158
7	Ohio	11,799,453	11,824,034	11,883,304
8	Georgia	10,713,755	11,064,432	11,180,878
9	North Carolina	10,441,499	10,881,189	11,046,024
10	Michigan	10,079,338	10,083,356	10,140,459

**Top 10 States by Numeric Growth: 2023-2024**
Rank	Geographic Area	April 1, 2020 (Estimates Base)	July 1, 2023	July 1, 2024	Numeric Growth
Source: U.S. Census Bureau, Vintage 2024 Population Estimates
1	Texas	29,149,458	30,727,890	31,290,831	562,941
2	Florida	21,538,192	22,904,868	23,372,215	467,347
3	California	39,555,674	39,198,693	39,431,263	232,570
4	North Carolina	10,441,499	10,881,189	11,046,024	164,835
5	New York	20,203,772	19,737,367	19,867,248	129,881
6	New Jersey	9,289,014	9,379,642	9,500,851	121,209
7	Georgia	10,713,755	11,064,432	11,180,878	116,446
8	Arizona	7,158,110	7,473,027	7,582,384	109,357
9	Washington	7,707,586	7,857,320	7,958,180	100,860
10	South Carolina	5,118,252	5,387,830	5,478,831

On a school lunch menu in rural Goshen, Indiana, is pizza, caprese sandwiches, hard-boiled eggs, and tater tot casserole.

It may seem like nothing special (save maybe the Midwestern flare), except it is. Some of those very ingredients are grown and sourced by students just outside the cafeteria walls.

With the help of a USDA grant, Bethany Christian Schools has grown its farm-to-school (rather, farm-at-school) program to include a greenhouse, garden beds, a 13-head chicken coop, and pear trees. It exists in large part thanks to Tara Swarzendruber, the K-12’s food services and farm-to-school director.

Photo Credit: Courtesy Bethany Christian Schools

“My goal was sort of to transform our menu to reflect more of the local foods that are available here in Indiana,” says Tara Swarzendruber, food services and farm-to-school director at Bethany Christian Schools.

“We’re working to give [students] more tactile experiences,” particularly among younger students, she says. “A lot of them, you know, spend a lot of time on iPads and screens … But this is a very physical experience of experiencing a food, a new food. And then the next week we’ll have it in the cafeteria for them to try there too.”

That experience looks like tending to the gardens and caring for chickens. Some students save seeds to replant; others lay down newspaper and grass clippings to prevent weeds.

Picking peppers, harvesting spinach and lettuce, going to butcher chickens once a year—it’s all in the curriculum. And for good reason, science teacher Amy Thut says.
She once overheard a student say going out into the garden relieves her anxiety. Another was inspired to plant tomatoes at home, meticulously watching them grow. They learn about food systems and how everything is connected.

“Spending time outdoors smelling the fragrant basil plants, feeling the wet soil, listening to insects chirping, seeing butterflies or earthworms, and tasting tomatoes or hot peppers is a full sensory experience,” Thut says.

“Students benefit academically, socially, and emotionally from this time outdoors.”

According to the South Dakota State University Extension, benefits of farm-to-school programs on students and staff include: grade and test score improvements, healthier food choices, more food system knowledge, better self-esteem and morale, and hands-on/experimental teaching and learning.

In the spring, Thut works with her high school environmental science students to plant garden beds. Think cucumbers, tomatoes, peppers, herbs, and flowers, which are simple for cafeteria staff to get on plates, she says.

Photo Credit: Courtesy Bethany Christian Schools

In the summer, a high school student (with the help of grounds staff) will water and weed the gardens, keeping bellies full through October. Then it’s time for the “fresh cart” come wintertime: Buy a meal (or use a free or reduced lunch pass) and get unlimited access to fresh fruit and vegetables all day. On the cart, you might find pea and sunflower shoots grown by sixth graders. Or chive flowers, hand-cut by Swarzendruber.

“My goal has always been, in the cafeteria and as we’ve been transforming [the program], that the educational experience for students doesn’t stop during the lunch period,” Swarzendruber says.

Her pointers for schools, or even just families, looking to follow a similar model: Lean into what you’re excited about, if even just a little. Then, start small.
That’s what Bethany Christian Schools did some dozen years ago: Take a handful of seeds and one small garden, and watch it all grow.

Amy Felegy, Culture Reporter

Amy Felegy (she/her) is a culture reporter at Arts Midwest. She specializes in finding and sharing stories on boundless creativity, and has been a professional journalist for eight years.

By Indiana Department Of Natural Resources

Usher in 2025 with other outdoor lovers at one of the many First Day Hikes offered Jan. 1 at Indiana’s state parks and lakes.

First Day Hikes are a healthy way to start the new year. They offer a chance to get outside, exercise, enjoy nature, and connect with friends. Find one near you at on.IN.gov/INStateParkEvents.

The hikes are organized by Indiana State Parks in cooperation with America’s State Parks. They will take place in all 50 states. First Day Hikes originated more than 20 years ago at the Blue Hills Reservation, a state park in Milton, Massachusetts. The program was launched to foster healthy lifestyles and promote year-round recreation at state parks. For more information, visit America’s State Parks website at stateparks.org.

The hikes are listed below. More may be added, so check the website if your favorite place isn’t listed. Make sure to wear sturdy, comfortable shoes and dress for the weather.

o   Brookville Lake. Meet at the Campground Shelter at Mounds State Recreation Area at 11 a.m. to hike the Wildlife Wander Trail, a .75-mile hike that should take approximately 45 minutes.

o   Brown County State Park. Two hikes will be offered. A .25-mile accessible hike on the Friends Trail will take place at 10 a.m. Meet at the park office. Hot chocolate will be available there afterward. A moderate 1.2-mile hike will take place on Trail 7 at noon. Meet at Ogle Lake. A bonfire and treat will be available after the hike at Ogle Lake Picnic Shelter.

o   Chain O’Lakes State Park. Meet at the boat rental parking lot at 11 a.m. This guided hike is about 1.5 miles over easy terrain and should last about 1.5 hours. Hot cocoa and cookies will be served afterward. A $1 donation for the cookies is suggested.

o   Charlestown State Park. Meet at the parking lot at 10 a.m. for a 2.5-mile hike to Rose Island on trails 3 and 4. This hike takes approximately two hours and is considered moderately rugged.

o   Clifty Falls State Park. Meet at Clifty Shelter at 10 a.m. This 1.5-hour moderately rugged hike is on trails 7 and 6, which meander along the east side of Clifty Creek with scenic views of the canyon below. Refreshments will be provided afterward.

o   Deam Lake State Recreation Area. Meet at the parking lot at the entrance of the campground at 10 a.m. for a 2-mile hike of the Lake Vista Loop. Runners of any level can meet at the same location to complete a 3- or 5-mile loop through the campground and adjacent roads. Hot chocolate and snacks will be provided afterward.

o   Falls of the Ohio State Park. Meet at the Interpretive Center at 1 p.m. for an exploration hike to the fossil beds. Learn about Devonian sea life as well as plants and animals that live along the river’s edge. Bring binoculars to look for winter birds. The Interpretive Center will offer access to restrooms before and after the hike but will otherwise be closed.

o   Fort Harrison State Park. Meet at Delaware Lake Shelter at 10 a.m. or 1 p.m. for a 2-mile hike on Harrison Trace, a paved trail. Hot chocolate will be provided at noon.

o   Hardy Lake. Meet at the main trailhead for an easy ¾ -mile introductory birding hike at 11 a.m.

o   Harmonie State Park. Meet at the campground overflow parking lot at 1 p.m. CT for a hike of Trail 5. Hot cocoa and cookies will be available afterward, and donations are welcome.

o   Indiana Dunes State Park. Meet at the City West Shelter for a 2-mile-long loop along the beach and Trail 7 starting at 10 a.m. Enjoy snacks and a cozy campfire provided by Friends of the Indiana Dunes.

o   Interlake Off-road State Recreation Area. Participants must provide their own ORV. All ORV rules and regulations apply. Interlake will be open, and participants can stop in the office to purchase their 2025 ORV pass.

o   Lieber State Recreation Area. Meet at the campground parking lot for a 1.5-mile hike at 10 a.m. on the newest trail at Lieber SRA. Hot chocolate, cookies and a warm fire will be available afterward at the Nature Center.

o   Lincoln State Park. Meet at the Nature Center at noon CT for a hike across the dam to the Civilian Conservation Corps camp at the front of the property. The hike will showcase the CCC’s lasting impact on the park.

o   McCormick’s Creek State Park. Meet at Centennial Shelter for hot chocolate and cookies, then hike along the Echo Canyon Trail at your own pace. The event runs from 1 to 4 p.m.

o   Mississinewa Lake. Join Upper Wabash Interpretive Services staff at 10 a.m. for a 1-mile stroll through the woods. Dress for the weather. Friendly dogs on leashes are welcome. Advance registration is requested by calling 260-468-2127.

o Monroe Lake. Meet at the Bay View Shelter in Fairfax State Recreation Area for the annual First Day Trail Run/Walk. Check-in begins at 2:15 p.m. Races will begin at 3:30 p.m. Participants can choose from a 1.3-, 2.9-, or 3.7-mile course. Advance registration is available through Dec. 30 for $15 at bit.ly/monroefirstday. Same-day registration is $20, cash or check only. Hot chocolate, snacks, and food will be available until event ends at 5 p.m.

o   Mounds State Park. Meet at the Nature Center at 5:30 p.m. for a guided a hike to the Great Mound. The hike is along the paved accessible path and lasts approximately 45 minutes. The Nature Center will open at 4:30 p.m. to welcome hikers.

o   O'Bannon Woods State Park. Join the park staff at Wyandotte Woods State Recreation Area at 10 a.m. for a half-hour tour of Little Wyandotte Cave.

o   Ouabache State Park. Meet at the bison enclosure parking lot at 10 a.m. for a hike around the bison enclosure. The hike is on a mostly level gravel surface and includes a stop at the feeding station to observe the bison up close.

o   Patoka Lake. Meet at the Nature Center at noon for a .6-mile hike of Trail 4. Hot chocolate will be available afterward.

o   Pokagon State Park. Enjoy a 2.5-mile hike through the park’s beautiful winter landscapes. The hike will begin at the CCC Shelter at 9 a.m. Refreshments provided by the Friends of Pokagon will be available after the hike at the CCC Shelter. Parking is available in the main beach and CCC Shelter parking lots.

o   Potato Creek State Park. Meet at 2 p.m. at the Nature Center for a 1-mile moderate hike on Trail 1, then warm up around the fire with s’mores and hot drinks. Bring binoculars in hopes of seeing eagles and other wildlife.

o   Prophetstown State Park. Meet at the Coneflower Shelter in Prairie View Picnic Area at 1 p.m. for an easy 2-mile hike.

o   Raccoon State Recreation Area. Meet at 1 p.m. at the beach house for a hike about some of the history hidden in plain sight around the beach area.

o   Redbird Off-road State Recreation Area. Meet at the office at 11 a.m. for a motorized “hike.”

o   Shades State Park. Meet at Hickory Shelter at 11 a.m. for a rugged hike of Trail 1, which will include Devil's Punch Bowl, Silver Cascade Falls, and Prospect Point. Come a few minutes early for a warm beverage and a treat.

o   Salamonie Lake. Hike along Salamonie Lake's Tree Trail and enjoy s'mores afterward. Meet at the Interpretive Center at 4:30 p.m. Advance registration is requested by calling 260-468-2127.

o   Shakamak State Park. Meet at the Historic Log Cabin for a hike at 1 p.m. Hot chocolate and cookies will be provided afterward.

o   Spring Mill State Park. Meet at Spring Mill Inn at 9 a.m. for a 1.5-hour hike through three nature preserves. Meet at Gus Grissom Memorial parking lot at 10 a.m. for a .25-mile accessible hike on Trail 6 with great views of the karst landscape. Afterward, meet at Spring Mill Inn for hot chocolate and snacks in the Lakeview Room.

o   Starve Hollow State Recreation Area. Meet at the Forest Education Center at 2 p.m. for a hike around the campground and lake’s edge. Hot chocolate will be provided.

o   Summit Lake State Park. Meet at the park office at 9 a.m. to enjoy coffee and snacks. At 10 a.m., join park staff for a prairie hike.

o   Tippecanoe River State Park. Meet at the fire tower parking lot at 11 a.m. for this .5-mile hike, which will include a talk on the history of the fire tower and its preservation.

o   Turkey Run State Park. Meet at the Turkey Run Inn lobby at 11 a.m. for a guided hike through Rocky Hollow. Hiking boots are recommended. Warm beverages and treats will be provided in the Strauss Room of the inn at 10 a.m.

o   Versailles State Park. Meet at the Oak Grove Shelter parking lot at 10 a.m. for a challenging 3-mile hike of Trail 1. Refreshments provided afterward at Oak Grove Shelter.

o   Whitewater Memorial State Park. Meet at Poplar Grove Shelter at 2 p.m. for a 2.5-mile hike of the Memorial Loop Trail that should take approximately 90 minutes.

By referring consumers to an Indiana-led multistate settlement, federal officials this month tacitly recognized the excellence of Attorney General Todd Rokita’s team.

In announcing its own settlement Dec. 10 with a Puerto Rico-based health care clearinghouse following a data breach, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) pointed consumers to an Indiana-led 33-state settlement with the same company reached more than a year earlier.

“The outstanding attorneys in our Consumer Protection Division are vigilant in safeguarding Hoosiers from corporate misconduct and protecting patient privacy,” Attorney General Rokita said. “It comes as no surprise to me that others would regard our work product as a gold standard.”

Both the federal and state settlements resolve allegations that Inmediata Health Group LLC violated state and federal laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), by exposing consumers’ protected health information online in a data breach.

In a press release, federal officials stated, “Under the terms of the settlement, Inmediata paid OCR $250,000. OCR determined that a corrective action plan was not necessary in this resolution as Inmediata had previously agreed to a settlement with 33 states that includes corrective actions that address OCR’s findings in this matter.”

Inmediata’s own investigation revealed that a coding issue potentially exposed the electronic protected health information of approximately 1.5 million U.S. individuals.

Under the Indiana-led settlement, Inmediata agreed to overhaul its data security and breach notification practices and make a $1.4 million payment to states — including more than $131,000 to Indiana.