INDIANAPOLIS | State Sen. Karen Tallian, D-Ogden Dunes, will lead the effort to expand Indiana's Medicaid program under the Affordable Care Act, potentially providing health coverage to about 400,000 additional low-income Hoosiers at little cost to the state.
"It's not only fiscally sound to do this, but I believe it's fiscally irresponsible to not do it," Tallian said.
Tallian is sponsor of Senate Bill 540 making eligible for Medicaid all Hoosiers earning less than 133 percent of the federal poverty level, which is $14,856 for an individual or $30,657 for a family of four.
Under the Affordable Care Act, also known as Obamacare, the federal government will pick up 100 percent of Medicaid costs for these new enrollees for three years starting in 2014. The state share increases after that but will never top 10 percent.
A General Assembly study found that between 2014 and 2020, an expanded Medicaid program would bring up to $12 billion in additional federal funds to Indiana.
Besides providing health coverage for the working poor, that money also would create jobs, as hospitals and clinics would see more patients and be assured of getting paid for their care, Tallian said.
She said Indiana would spend approximately $100 million a year on administrative costs for an expanded Medicaid during that period, but revenue from a 2007 cigarette tax increase used to fund the Healthy Indiana Plan could be redirected to cover those costs. HIP is not allowed under federal rules for an expanded Medicaid program.
The 2010 Affordable Care Act requires all states increase their Medicaid eligibility, but the U.S. Supreme Court, in its decision upholding the constitutionality of Obamacare, said states cannot be penalized for not following the law.
Republican Gov. Mike Pence said Wednesday he would look at any expansion plan approved by the legislature but is inclined to only support a plan if it doesn't add to state spending and includes participant contributions like the Healthy Indiana Plan requires.
"I think Indiana has set the pace nationally for providing the kind of health care coverage for our citizens that is better for our citizens and better for taxpayers," Pence said. "I think it's imperative that any consideration of any Medicaid expansion would have to be predicated on it being fiscally responsible and giving Indiana the ability to continue to innovate."
State Rep. Ed Delaney, D-Indianapolis, said Pence shouldn't wait for the legislature to act and needs to be part of the discussion on how to make Medicaid expansion happen.
"I'm paying to fund this program on a national basis so I'm going to pay for the guy in Illinois, the guy in Michigan, to get this health care but I'm not going to give it to my fellow Hoosier?" Delaney asked. "We don't want our people to wake up next January saying, 'If I lived in Illinois I'd have coverage.'"
Tallian's legislation expanding Medicaid eligibility is awaiting action by the Senate Appropriations Committee.
An Indiana resident must currently 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 — and have limited assets to enroll in Medicaid.