INDIANAPOLIS | House Democratic Leader Scott Pelath, D-Michigan City, is only half-joking when he describes a new law permitting the sale of uninspected frozen rabbit meat at roadside stands as the jobs bill of the just-concluded 2013 legislative session.
That's because he said he can't believe the Republican-controlled General Assembly "punted on the biggest jobs bill in a generation" by refusing to expand Medicaid eligibility to 400,000 uninsured Hoosiers, paid for entirely with federal funds for the first three years.
"Come Oct. 1, the taxes that we send to Washington will start paying for people in Illinois to enroll in health care, for people in Kentucky to enroll in health care ... people in Ohio, people in Michigan," Pelath said. "They'll be using our tax money to sign up for health care coverage so they don't have to go to the emergency room."
The Indiana Hospital Association estimates expanding Medicaid as directed by the Affordable Care Act, also known as Obamacare, would bring Indiana $10.45 billion in federal health spending and finance 30,000 jobs through 2020.
Republican Gov. Mike Pence said he's been talking with federal health leaders about crafting an Indiana alternative to Medicaid expansion that would require participants pay more for their care, similar to the high-deductible Healthy Indiana Plan.
He won't say how his proposal is being received.
"We continue to be involved in very significant discussions with officials in Washington about using the framework of the Healthy Indiana Plan for any future expansion of Medicaid," Pence said.
Pelath said senseless Indiana Republican opposition to Democratic President Barack Obama means Hoosiers lose twice -- they won't get the health care jobs and, more importantly, they won't receive health care.
"Your constituents are going to start calling you and saying, 'What do I do?'" Pelath said. "There's going to be confusion and you're going to have to explain, 'Well, we turned it all over to the governor; his way didn't work, and we don't have a Plan B and you're out of luck.' "
"And, by the way, if you get sick, just go to the emergency room."
The first-year governor and former congressman describes Medicaid, which currently serves 1.2 million low-income and disabled Hoosiers, as a "broke and broken" system that's "not in Indiana's interest to expand," because he doubts the federal government will follow a law requiring them to pay 90 percent of the cost of new Medicaid enrollees in 2020 and beyond.
Pelath noted there's little to indicate the federal government will cut a separate deal for Indiana just because Hoosier Republicans want to be obstructionist.
"Gov. Pence's way on health care expansion probably is not going to work," he said.
As a result, Pelath said, Hoosiers with health insurance will pay thousands of dollars in higher premiums over the next five years to subsidize a projected $2 billion in uncompensated care at hospital emergency rooms.
He said businesses also will be less likely to move to Indiana because they won't want to pay higher employee health care expenses when they can easily locate in a neighboring state where all residents will have health insurance.
The issue of expanding Medicaid eligibility stems from the 2012 U.S. Supreme Court ruling upholding the constitutionality of Obamacare. The nation's high court said even though the law requires expansion, states cannot be punished if they fail to do so.
Under the Affordable Care Act, Medicaid eligibility would extend 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.
Currently, an Indiana resident must 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.