State should go for expansion of Medicaid

By the H-T editorial board
The Herald-Times (Bloomington, Ind.), Jan. 10, 2013

Gov.-elect Mike Pence should support an expansion of Medicaid in Indiana. And while he’s at it, he should name Dr. Rob Stone of Bloomington his chief adviser on medical and health care issues.Dr. Rob Stone

Stone’s background includes working 28 years as an emergency room physician and nearly that long as an outspoken advocate for making sure access to health care is within reach of as many people as possible. He’s not a big fan of much of the Affordable Care Act because it doesn’t go far enough for him. He is a fan of the Medicaid expansion, though, because it would provide about 363,000 uninsured Hoosiers a way to afford necessary health care.

Medicaid, don’t forget, is the health care safety net for people with disabilities, the poor and the elderly. The most important reason to expand it is that more individuals who really need help will get help.

But that’s not the only reason. This would be good for the state for a lot of reasons.

As Stone said in a presentation this week, “People live sicker and die younger without insurance.” On the flip side, people who are healthier and — well, alive — have a much better chance at being productive and contributing to society.

And, he estimated, one life would be saved for every 1,000 newly insured people. In other words, 363 Hoosiers a year would not die if 363,000 additional Hoosiers can gain access to health care.

Cost is a main reason opponents cite when encouraging state leaders not to expand Medicaid. It would be an expensive program to expand.

But, Stone points out, the return of federal funds to state money would be at least $11 to $1. And the state money, Stone says — estimated at $50 million to $150 million — could come from a $121 million cigarette tax currently earmarked for the Healthy Indiana Plan, as well as $48 million in a high risk insurance pool. Neither program would be needed with the expansion of Medicaid, meaning state funds would simply be transferred from one use to another.

Meanwhile, the Medicaid reimbursement money would go into the state’s economy through doctors, nurses, hospitals and other health care-related jobs.

One more reason popped up last week that should help the state decide to take this deal from the federal government. A federal judge ruled that Indiana has been “deliberately indifferent” to mentally ill inmates in state prisons. It seems likely the state will need to spend more than the $100 million it spent in 2012 on inmate health care in reaction to the ruling. Many of those mentally ill prisoners could be covered by Medicaid if the program is expanded, negating the need to spend more state money in that area.

Stone calls the opportunity to expand Medicaid so more people are treated and federal funds come to Indiana instead of going elsewhere as “a no-brainer” and as grabbing “low-hanging fruit.” We agree with him, and suggest Gov.-elect Pence and the Republican majority in the General Assembly listen to him, too.

PNHP note: See also Dr. Stone's opinion piece in the Jan. 3 edition of the Indianapolis Star on the issue of Medicaid expansion.