State should embrace expansion of Medicaid

By Rob Stone, M.D.
Indianapolis Star, Letters, Jan. 3, 2013

The Affordable Care Act is coming. Gov.-elect Mike Pence has said the ACA will “double down on an already broken and unaffordable Medicaid system, and, left unchecked, it will destroy all the progress we have made on health-care access, not to mention our economic competitiveness and fiscal solvency for our state and country.” I disagree.

Out of the 800,000 Hoosiers currently without health insurance,363,000 could be provided Medicaid coverage. According to a Harvard study on preventable deaths due to lack of health insurance, 363 Hoosiers per year, or 1 person a day would be saved from a needless preventable death. In my work toward a national health program, I’ve heard far too many people say that they are afraid to see a doctor because they can’t afford health insurance.

Right now in Indiana if a family of four earns more than $11.50 a day, it’s too much to qualify for Medicaid. Under the ACA the same family of four can earn $30,000 a year and be covered. That’s equal to two adults working 80 hours a week at minimum wage. This would be an incredible boon to working Hoosier families, lifting the threat of financial ruin caused by an accident or illness, and opening the door to preventative care.

Experts argue how much this will cost the state. Estimates range from $50 million to as much as $150 million a year, but none contest the amount of federal money that would come into the state if we proceed – $1.7 billion a year, which would go to Indiana hospitals, doctors, nurses, and into the state’s economy. A study in Missouri predicted 24,000 jobs would be created there.

Congress was aware of how large a chunk Medicaid currently takes out of states’ budgets and made this a deal too good to refuse, with a federal contribution of more than $11 for every $1 of Indiana taxpayers’ money. If Hoosier lawmakers don’t take the deal, our federal tax dollars will go to states that do.

Where could Indiana find the money to pay our share? The Medicaid expansion would cover nearly all of the inmates in Indiana’s prisons and could save the General Fund $100 million every year. The cigarette taxes collected for the Healthy Indiana Plan, $121 million, alone would likely cover the entire cost. The state’s high-risk insurance pool (ICHIA) currently costs $48 million annually, and it will no longer be needed in 2014. We are just beginning to add up all the savings.

The fiscally responsible thing to do is for Hoosiers is to set aside our partisan differences and participate in this expansion of Medicaid. It will create jobs, strengthen our hospitals, not to mention make us healthier.

Rejecting Medicaid would be a huge blow to Indiana. If Hoosiers are serious about the right to life, it begins with caring for the living, saving 363 lives every year.

Stone, a medical doctor, is director of Hoosiers for a Commonsense Health Plan.