Commentary: Indiana still can’t afford the Affordable Care Act – at least not as is
By Abdul Hakim-Shabazz
IndyPolitics.org
Abdul Hakim-Shabazz is an attorney and the editor and publisher of IndyPoltics.Org.
As much I love the sound of my own voice, I really don’t like to repeat myself. Unfortunately, this is about to be one of those occasions.
Back in July I wrote a column arguing that the state of Indiana could not afford to participate in the Affordable Care Act. I still pretty much stand by that original column.
This past week House Minority Leader Scott Pelath and Senate Democratic Leader Tim Lanane called on Gov. Mike Pence to go forward and participate in the ACA, which would expand Medicaid coverage to hundreds of thousands of Hoosiers who currently don’t have coverage.
Their logic is that costs will drop overall because more people will have access to health care and the federal government will pick up 100 percent of the tab in the short run.
I wrote back in July, and I’m writing again: Does anyone really believe that in an age of budget cuts and sequestration that the federal government is really going to follow through on its promise?
Just look at how much trouble lawmakers have passing a transportation bill or a farm bill? Does anyone really think that Medicaid will be any different?
Supporters of the ACA point to recent moves by governors in Ohio and Arizona to participate in the federal program as reason to participate too. Michigan is looking to join as well. Supporters say Indiana will become an “island of uninsured.”
But with all due respect, does anyone really think that putting 500,000 people on the government dole between now and 2020 is a good idea?
Luckily, the governor and Indiana lawmakers have been hesitant to get on board this taxpayer-funded gravy train.
Gov. Mike Pence has said he is open to participating in the ACA under the right conditions – one that it be modeled after the Healthy Indiana Plan, which includes a co-pay for some services so that users of the system have some skin in the game. Sen. Luke Kenley, budget guru, has suggested the state negotiate with the feds as well.
I argue that unless the federal government allows Indiana to use the Healthy Indiana Plan as a model, there is no way it should participate in the Medicaid expansion. It’s bad enough the state’s medical device industry is being hit with a tax increase to help pay for the expansion. But to jump into it wholeheartedly without trying to negotiate something out of the deal is equivalent to using your adversary’s knife to cut your own throat.
I want people to be insured as well. But the number one rule of medicine is to do no harm and ease a patient’s pain and suffering. Please tell me how putting more people on the government dole with no skin in the game and taxing an industry that employs 18,000 Hoosiers to help do it is good for anyone?
The only person who would be happy about this kind of medical treatment would be Jack Kevorkian – and usually his patients didn’t stick around long enough to complain about the results.
Abdul is an attorney and the editor and publisher of IndyPoltics.Org. He is also a frequent contributor to numerous Indiana media outlets. He can be reached at abdul@indypolitics.org.
February 12, 2013 - 2:38 pm
If Indiana does not participate in the ACA, it will be a disservice to the citizens of the state.
As a Medicare recipient, I do not consider myself “on the dole.” The insurer is the Federal Government and the bill is footed by taxpayers and by premiums I pay every quarter. I have private insurance to pick up any co-pays. I would also not consider persons on Medicaid to be “on the dole.” There is a clear public interest in having the whole population covered by adequate health insurance; many countries do this through single payer systems with better health outcomes and lower costs than the US. Unfortunately, our political leadership has not gone that route, so we are left with an inadequate, hybrid system. The ACA is not going to solve all our problems, but if we work with it we can make things better.
The reason states like Ohio, Michigan and Arizona have decided to participate in the ACA is that it makes fiscal sense. I think your argument that the Federal Government will not meet its commitment to finance the bulk of the cost of Medicaid expansion is wrong. A commitment of this nature and seriousness could not be reneged upon without the most serious consequences, and it will not be. While there is a lot of blah-blah now about cutting budgets, the situation is not nearly as serious as it is made out to be and cuts to the sorts of social programs we are talking about here will be on the margins only — and in fact that is all that will be needed. For Indiana to pass up this opportunity in order to make a political point will be a serious mistake.
February 12, 2013 - 8:35 pm
You are on the dole. Duh.
February 13, 2013 - 12:32 pm
Planning to turn down Medicare when you reach 65, or go on the dole?
February 13, 2013 - 8:52 am
SO…I not only have to pay for MY families health insurance; but now I’ll get to pay for numerous others as well! The Federal government is always ready to help…using MY money…BTW Uncle Ralph, you are on the dole..