2013 Indiana General Assembly

House puts Medicaid expansion entirely in governor's hands

2013-04-08T23:45:00Z 2013-04-09T08:37:03Z House puts Medicaid expansion entirely in governor's handsDan Carden dan.carden@nwi.com, (317) 637-9078 nwitimes.com
April 08, 2013 11:45 pm  • 

INDIANAPOLIS | A top House Republican has halted legislation requiring Republican Gov. Mike Pence negotiate with the federal government the terms of an alternative health care plan for low-income Hoosiers, as Pence refuses to expand Medicaid eligibility in Indiana.

The chairman of the House Ways and Means Committee, state Rep. Tim Brown, R-Crawfordsville, announced Monday he will not hold a vote on Senate Bill 551 on Tuesday, the final day for House committees to act on Senate-approved legislation — in effect killing the measure.

As a result, the Republican-controlled General Assembly has put entirely in Pence's hands, with no limits or guidelines, the fate of an estimated 400,000 Hoosiers who otherwise would be eligible for Medicaid under the federal Affordable Care Act.

State Rep. Ed Clere, R-New Albany, the chairman of the House Public Health Committee, said he was "very disappointed" by Brown's decision and plans to continue seeking ways for the Legislature to have a voice on health care reform before it adjourns April 29. A similar measure, also sponsored by Clere, died in the House in February.

"This is too important of an issue just to stop working on it," Clere said.

Last week Clere rewrote the legislation to remove a Senate mandate that any negotiations between the state and the federal government over expanding Medicaid eligibility be conditioned on the federal government's giving the state all the money it spends on Indiana Medicaid — an extremely unlikely prospect.

He added a requirement that the governor negotiate a reasonable Medicaid expansion, possibly following the contours of the high-deductible Healthy Indiana Plan currently used by some 40,000 low-income Hoosiers.

Pence said Thursday he opposed the change and preferred the Senate version of the legislation.

At the same time, Pence administration leaders have claimed a 2011 law allowing the Family and Social Services Administration to negotiate Healthy Indiana Plan issues with federal health officials gives them all the authority they need to also negotiate Medicaid expansion without further legislative input.

State Rep. Charlie Brown, D-Gary, the top Democrat on the Public Health Committee and a co-creator of the Healthy Indiana Plan, said he found that claim dubious since the U.S. Supreme Court ruling allowing states to opt out of Medicaid expansion was still a year away when the law was enacted.

"How could we have passed legislation that says I'll allow you to do something that isn't in existence yet?" he asked.

Charlie Brown said he believes Pence is "playing chicken" with the federal government to show his resistance to "Obamacare" and improve his chances in a possible 2016 Republican presidential primary.

Meanwhile, Senate Democrats spent much of Monday proposing additions to House Bill 1001, the 2014-15 state budget. Their proposals included an expansion of Medicaid to Hoosiers earning 133 percent of the federal poverty level, which is $14,856 for an individual or $30,657 for a family of four, as envisioned by the Affordable Care Act.

State Sen. Karen Tallian, D-Ogden Dunes, said Indiana needs to expand Medicaid eligibility as a back-up plan in case the governor's negotiations fail.

However, her proposal to expand Medicaid from 2014-16, when the federal government will pay 100 percent of the costs for new enrollees, was rejected on party lines, as were several variations requiring the governor to include certain topics in his negotiations.

During debate, state Sen. Luke Kenley, R-Noblesville, repeatedly urged Senate Republicans to vote against Tallian's proposals because they belonged with the Medicaid issues in Senate Bill 551, not the state budget.

Shortly after the Senate voted down Tallian's final proposed revision, Senate Bill 551 was declared dead in the House.

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