INDIANAPOLIS | Gov. Mike Pence and Republican state lawmakers have drawn a line in the sand on expanding Medicaid eligibility that all but guarantees some 400,000 uninsured Hoosiers will be unable to obtain or afford health coverage next year.
In a letter sent Wednesday to federal health officials, the Republican governor said he will not permit Indiana to expand Medicaid eligibility as envisioned by the 2010 Affordable Care Act, which Pence voted against as a member of Congress.
"To do so, in my view, would be to expand a highly flawed program in Indiana and place an enormous burden on Hoosier taxpayers," Pence said.
Instead, Pence asked permission to continue using the Healthy Indiana Plan for current enrollees as well as adapt the health insurance program to include those low-income Hoosiers set to become eligible for traditional Medicaid in 2014.
"I believe that the Healthy Indiana Plan should serve as the starting point for all future discussions of health care reform in Indiana," Pence said.
Pence's decision was backed by Republican-led committees in the House and Senate, which separately approved legislation Wednesday barring Medicaid expansion unless the federal government allows Indiana to run the program its way. That is unlikely to happen.
House Democratic Leader Scott Pelath, D-Michigan City, said Pence is making a mistake and needs to reconsider.
"This is the best thing we could do for short-term job growth because it would bring thousands of private-sector health care jobs to Indiana, and more importantly it would keep ... hundreds of thousands of residents from having that emergency-room physician, who is very expensive, be their first order of health care," Pelath said.
State Sen. Karen Tallian, D-Ogden Dunes, whose proposal to expand Medicaid following federal rules was rejected on a party-line committee vote, said partisanship is hobbling expansion.
"I think they want to claim we're holding the line on federal mandates, even if it requires shooting ourselves in the foot to do it," Tallian said.
Under the Affordable Care Act, also known as Obamacare, states are required to expand Medicaid eligibility to Americans 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.
However, states cannot be punished if they don't expand eligibility.
Without expansion, Hoosiers who otherwise would be eligible for Medicaid could not enroll in the program and also would be prohibited from obtaining federal tax credits to buy private insurance on the state's health insurance exchange.