2013 Indiana General Assembly

Pence may be required to negotiate with feds on Medicaid expansion

2013-04-01T11:26:00Z Pence may be required to negotiate with feds on Medicaid expansionBy Dan Carden dan.carden@nwi.com, (317) 637-9078 nwitimes.com
April 01, 2013 11:26 am  • 

INDIANAPOLIS | A House committee agreed Monday to require Republican Gov. Mike Pence negotiate with federal officials over a potential expansion of Medicaid eligibility in Indiana.

Senate Bill 551 was changed by the Public Health Committee to mandate, and not just authorize, Pence's Family and Social Services Administration negotiate terms and conditions that could lead to an estimated 400,000 uninsured Hoosiers joining the state's Medicaid rolls in 2014 as envisioned by the Affordable Care Act, also known as Obamacare.

"This bill attempts to give the administration maximum flexibility to negotiate once the Legislature is no longer in session, but it does require the administration to at least try and strike a deal," said state Rep. Ed Clere, R-New Albany, the committee chairman.

The panel removed nearly all limits on the terms Pence could demand, including stripping a provision approved by the Senate that conditioned negotiations on the federal government handing over all of the Medicaid money it spends in Indiana for the state to do whatever it wants with it.

The only remaining requirement is that Indiana be allowed to cancel any Medicaid expansion if, after 2020, federal funding for new enrollees drops below 90 percent. The federal government is set to pay the full cost for new Medicaid enrollees from 2014-16 and a declining share after that. 

Otherwise, Clere said Pence is free to ask the federal government to tie expansion to the Healthy Indiana Plan -- a high-deductible health insurance program for low-income Hoosiers -- or any other program, including a premium support model where the state would purchase private health insurance for Hoosiers who'd otherwise be Medicaid eligible.

"The administration would have broad latitude to design a plan for the expansion population," Clere said.

However, Pat Casanova, a top FSSA official, and state Sen. Pat Miller, R-Indianapolis, the Senate sponsor of the proposal, both said they don't support the revised legislation and will seek to alter it again as it moves through the General Assembly.

Both women said they believe the changes will limit Pence's negotiating power, though Casanova admitted she hadn't closely read the plan.

Pence has previously said he does not support any expansion of Medicaid, a joint federal-state program he claims is "broken."

Four Democrats and four Republicans voted to advance the revised legislation to the full House. Five Republicans voted no.

Earlier this year, Clere did not call a similar measure for a final vote by the Republican-controlled House when it became obvious the legislation did not have enough support to pass to the Republican-controlled Senate.

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