INDIANAPOLIS | State Rep. Charlie Brown, D-Gary, is not impressed with state efforts to dream up complicated workarounds to the Affordable Care Act when implementing the law would immediately provide health coverage to an estimated 400,000 low-income Hoosiers.
Republican Gov. Mike Pence, who voted against the Affordable Care Act in 2010 while serving in Congress, has refused to expand Medicaid eligibility in Indiana unless participants are required to directly pay a portion of their health care costs.
He recently asked for a meeting with federal health officials to discuss using the Healthy Indiana Plan, a state-run, high-deducible health insurance program, as an alternative to adopting the no-fee traditional Medicaid program.
"Unlike traditional Medicaid, the Healthy Indiana Plan gives its members 'skin in the game' with regard to their health care and lifestyle decisions," Pence said.
But Brown, who co-sponsored the 2007 law creating the Healthy Indiana Plan, said it's "bizarre" Pence is insisting on using it when the federal government will pay 100 percent of the costs for new Medicaid participants through 2016 and never less than 90 percent after 2020.
"Why would we not expand it if the feds are going to cover 100 percent for three years?" Brown said. "That means we are sending our tax dollars to all the bordering states."
Indiana will be an island of the uninsured come January, when low-income residents of Illinois, Michigan, Ohio and Kentucky can begin receiving Medicaid services without the additional fees or requirements Pence seeks to impose.
Unlike those states, where Medicaid eligibility will extend to a resident earning up to 133 percent of the federal poverty level, which is $14,856 for an individual or $30,657 for a family of four, Hoosiers will have to earn less than 22 percent of the federal poverty level — that's $2,457 for an individual or $5,071 for a family of four — to enroll in Medicaid.
Hoosiers earning between 22 percent and 100 percent of the federal poverty level will be in an especially tough spot -- they'll make too much to be eligible for Medicaid in Indiana, and too little to qualify for federal subsidies to buy private health insurance.
The Indiana Hospital Association estimates Indiana will lose $10.45 billion in federal funds it would have received over the next seven years if it had expanded Medicaid eligibility.
Brown, the top Democrat on the House Public Health Committee, also said Pence missed an opportunity to prove his devotion to state sovereignty when he refused to create an Indiana insurance marketplace.
Instead of the glitchy federal insurance website, Brown said Hoosiers could have had their own functioning system for purchasing private health insurance if Pence hadn't decided to let the federal government run Indiana's marketplace.