Medicaid expansion focus of rally at Statehouse

By Dann Denny
Herald-Times (Bloomington, Ind.), Nov. 19, 2013
Physician Rob Stone is among a group of Medicaid-expansion advocates who are gathering from 1 to 2 p.m. Tuesday at the Statehouse to urge Gov. Mike Pence and the Indiana Legislature to expand Medicaid in the Hoosier state.

“We’re aiming for 1,000,” said Stone, a Bloomington physician and director of Hoosiers for a Commonsense Health Plan. “I’d be surprised if we get that many, but I’ve love to see several hundred show up.”

It was several weeks ago that Stone suggested having the Statehouse rally, phoning in the idea to a gathering of a statewide coalition called Cover Indiana at the AARP headquarters in Indianapolis. Hoosiers for a Commonsense Health Plan is a member of Cover Indiana, as are groups such as the AARP, United Way of Indiana, League of Women Voters and Indiana Hospital Association.

When Stone suggested the grassroots gathering take place in February, Indiana state Rep. Ed Clere — a Republican from New Albany representing District 72 — suggested Nov. 19 because that is the day Indiana lawmakers meet to organize the legislative session. Others at the meeting concurred.

“I’m excited,” Stone said. “I don’t plan on pulling out Kryptonite and chaining myself to the governor. I just want to talk to some people and urge them to really think about this issue, because we have to find a way to make this happen.”

Stone said he’s been encouraged by the actions of Clere, who’s been traveling around the state for the past few months telling different groups that his party has it wrong on Medicaid expansion.

“I think the political landscape may be changing,” Stone said. “Last year, the governor said he did not like Medicaid expansion and his party had a supermajority in the House and Senate, so it appeared as if nothing would happen. But now, with Ed Clere going all over the state saying his party has it wrong, and Republican governors in Ohio and Michigan expanding Medicaid even though they’re not fond of the Affordable Care Act, there may be a chink in the Republican Party’s armor.”

Stone and his wife, Karen, are leaving Tuesday morning for Indianapolis, where they will have a face-to-face meeting at 8:45 a.m. in the Statehouse with District 60 state Rep. Peggy Mayfield to talk about Medicaid expansion.

Stone said he’s hoping Pence will follow the lead of Republican John Kasich, governor of Ohio, who found a way to expand Medicaid despite stiff resistance from the Ohio Legislature.

“He tried to convince the Republicans who control the House and Senate to expand Medicaid, but ran into a brick wall,” Stone said. “But he found a way to free up some funds and expand the program without the full cooperation of the Legislature. He said when he’s at the Pearly Gates, he will not be asked what he did to make government smaller but what he did to take care of the people in his state.”

Stone said if Indiana, which now has about 800,000 uninsured residents, would expand Medicaid to include adults living at or below 133 percent of the federal poverty level — which states have the option of doing under the Affordable Care Act — it would provide coverage for 300,000 to 400,000 more Hoosiers. The federal government would cover 100 percent of the cost of expanding the program during the first three years, and then Indiana would have to begin paying a gradually increasing share that tops out at 10 percent of the cost.

“That will cost Indiana taxpayers between $50 million and $150 a million a year, which is certainly not chicken feed,” he said. “But it would bring an estimated $1.7 billion a year in federal money into Indiana’s Medicaid program. That would mean more than $11 of federal funds for every $1 of Indiana taxpayers’ money.”
He said the added cost to Hoosier taxpayers could be largely offset with a $121 million cigarette tax earmarked for the Healthy Indiana Plan, and $48 million in a high-risk insurance pool.

“Basically, Medicaid expansion is a deal too good to refuse,” he said.

Stone said when hospitals voluntarily endorsed the Affordable Care Act in 2009, they did so with the understanding that cuts to their Medicare reimbursements would be offset by an expansion of Medicaid.

“Now many hospitals, particularly small county hospitals, in the 20-some states that have not expanded Medicaid are at risk,” he said. “If Indiana does not expand Medicaid, there may be 20 to 30 small hospitals that may go out of business, and these hospitals are often the largest employer in the town with the highest-quality jobs.”

Healthy Indiana Plan

Gov. Pence has said he wants to use the state’s up-and-running Healthy Indiana Plan as a vehicle for Medicaid expansion.

“The Healthy Indiana Plan now covers about 38,000 of the 800,000 uninsured Hoosiers, so it would have to grow much larger,” Stone said. “And to meet the requirements of the ACA, it would have to undergo some big changes. For example, it would have to cover pregnancies, which it currently does not cover.”