INDIANAPOLIS — Supporters of a proposal allowing Northwest Indiana children who are very ill, age 6 or less and covered by Medicaid to be treated at a Chicago hospital, instead of having to travel to Indiana's capital city, have more time to advocate for the legislation.
The Senate Appropriations Committee postponed action on House Bill 1238 Thursday, following nearly two hours of sometimes heart-wrenching testimony by Region families, health advocates and hospital leaders that was uniformly in favor of the measure.
Nevertheless, state Sen. Ryan Mishler, R-Bremen, the committee chairman, said he still will call next week for a vote on his proposed amendment to eliminate the plan's Medicaid payment pilot program for the University of Chicago children's hospital, and instead establish a task force to study Indiana's Medicaid reimbursement rates at all hospitals in Illinois, Michigan, Ohio and Kentucky.
The Senate sponsor, state Sen. Ed Charbonneau, R-Valparaiso, said he plans to support Mishler's amendment, in part because he's not comfortable giving a single Chicago children's hospital a financial advantage over the five others in the city, when realistically every hospital in all of Indiana's neighboring states ultimately will want in.
"We can't focus on Medicaid and one hospital," Charbonneau said. "We have to focus on the big picture, and these states have to get together and start talking about these issues and getting them resolved."
State Rep. Ed Soliday, R-Valparaiso, the House sponsor, suggested that a better strategy would be to permit the University of Chicago pilot program to take effect while the task force does its work, as a kind of real-life case study that could serve as a basis for any task force recommendations.
"I'd really like to get this happening as soon as possible so we can understand the problem, understand the scope and have the least impact fiscally until we can understand that," Soliday said.
Currently, the legislation would require the Family and Social Services Administration to pay the University of Chicago children's hospital the same rates it pays for Medicaid-covered health care at Riley Hospital for Children in Indianapolis, which would cost the state approximately $1.5 million more each year.
Dr. John Cunningham, physician-in-chief at the University of Chicago Comer Children's Hospital, said last year it treated 495 Hoosier children under age 6 who were covered by Indiana Medicaid, and received payment amounting to just 10% of the hospital's usual charges for care, or one-third of what Illinois Medicaid pays.
"In other words, we can't even cover the cost of caring for those children," Cunningham said.
Donna Criner, director of the Northwest Indiana Cancer Kids Foundation, said that if the University of Chicago ever decided it was not worth serving Region families, it would be a logistical nightmare for the parents of premature babies or ill children to have to travel to Indianapolis for care, while still trying to work and take care of other needs at home.
To that end, she suggested opening the Medicaid reimbursement program to all Chicago children's hospitals, and removing the requirement that only treatments for children age 6 and under would be covered at the in-state Medicaid rate.
"Some cancers and many other child diseases require years of treatment," Criner said. "The Northwest Indiana region has access to some of the finest children's hospitals within sometimes as little as a 20-minute drive.
"Give these families the options that can make a difference in managing their entire family while managing their child's treatment."
No matter what happens next week with Mishler's amendment, the legislation still can be further revised by the full Senate, and changed again during the House-Senate conference committee process that will finalize the language prior to a vote in both chambers on whether to advance the measure to the governor.
The original version was approved 92-0 by the House in February.