This emerging scenario begs for a comprehensive statewide approach in a potential three-year time frame that Obamacare establishes for a Medicaid expansion. The state has world-renowned research universities; life science, orthopedic and pharmaceutical clusters; and consumer-driven policy innovation that resulted in a post-IBM “hybrid” safety net program at FSSA to the forging of the fledgling Healthy Indiana Plan.
Asked about a potential blue ribbon commission pulling the various areas of expertise together to forge a state-based health care approach for Hoosiers, Gov. Pence reacted by saying, “I take your point that if we have the opportunity to continue to advance the kind of health insurance innovation that is in the interest of Hoosiers’ health, then I’m open to doing that.”
Pence has asked the various state agencies to assemble an array of health metrics. “There is a lot of work left,” said Pence, who governs a state where 30 of the 92 counties offer no neo- or post-natal care facilities, impacting the infant mortality rate. “Other than public safety, there is no more important work that we do than the health and well-being of our people.”
The factors Indiana Republican leaders face are an aversion to any notion of a tax increase, as opposed to extending service to constituents.
Pence and Long cited the $25 million annual cost of running an Indiana-based health exchange. “My decision was based entirely on our analysis in the immediate days following my election that for the sum $25 million it would cost to operate, it would gain very little control over and above what Hoosiers would gain if the federal government operated the exchange,” Pence explained.
What the federal exchange has done is to force Hoosiers to seek coverage in a logistical cul de sac. While the Kentucky state exchange enrolled 33,561 in Medicaid and 7,011 in private insurance by mid-November, Indiana Republicans used the 701 who had successfully traversed the federal exchange as an “I-told-you-so” moment.