Whether you agree with Obamacare or not, it's hard to argue with the notion that going to the emergency room for routine medical care is not a sensible policy. Believe it or not, however, Indiana Gov. Mike Pence suggested that option instead of free federal dollars for Medicaid expansion.
Hoosier Democrats wanted Pence to expand Medicaid to reduce the number of uninsured people. The federal government would pay for the first several years of coverage. After that, the state would have to pick up its normal share of the cost.
Hoosier Republicans prefer the Healthy Indiana Plan created under then-Gov. Mitch Daniels. That program stresses individual responsibility, with a high deductible, to keep costs down.
Republicans won this fight, at least for now, with Pence announcing Tuesday the Centers for Medicare and Medicaid Services approved his request to continue the high-deductible Healthy Indiana Plan through at least 2014.
But about one-third of the 37,000 low-income Hoosiers on the plan will be forced out.
Effective Jan. 1, HIP participants cannot exceed the federal poverty level. So about 11,000 current participants who earn between 100 and 200 percent of the federal poverty level will soon be told their coverage will expire at the end of the year. They will be advised to buy private health insurance through the federally managed health insurance exchange that debuts Oct. 1.
Other low-income Hoosiers will take their place, up to 45,000 total participants.
Indiana has about 880,000 uninsured residents. Pence said about 500,000 of them will buy federally subsidized health insurance on the new health insurance exchange next year.
So what about the 330,000 Hoosiers who will remain uninsured?
Pence suggested they rely on hospital emergency rooms, charity care and local free clinics.
An emergency room provides some of the most costly care around. That's the very problem that launched the lengthy debate on health care reform.
Patients who can't afford routine medical care tend to go to the ER when their ailment is acute and they are out of options.
If the patient can't afford the care — and let's face it, if they could afford the care they could afford insurance — financial ruin is in the cards for that individual.
The unpaid bills are subsidized by those who do have insurance, driving up the cost of care for everyone.
This was a strong selling point for health care reform, the result of which is Obamacare.
It's also why House Democratic Leader Scott Pelath, D-Michigan City, and others in his party pushed so hard for Medicaid expansion in Indiana.
Brace yourself; the political fight over health care is far from over.
Meanwhile, as they say at Walgreens, "Be well." Especially if you're uninsured.