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March 4, 2013

HOWEY: Medicaid ideology ... and elusive answers

(Continued)

INDIANAPOLIS —

Indiana Senate President Pro Tempore David Long noted that State Sen. Pat Miller’s bill to expand the Healthy Indiana Plan passed the Senate, but quickly acknowledged that no one knows what the cost of HIP will be, even while denouncing Medicaid expansion in general. “I’ve never heard an answer if we just did the HIP plan,” Long said. “Can we afford that?”

But key Republicans view opting into the Medicaid expansion with the feds picking up 100 percent of the costs through 2020 as a slippery slope or Hotel California: once in “you can never leave,” as the Eagles might croon.

Another way to look at it is opting in gives Indiana three years to seek alternatives, and at no cost. Adding to this dilemma is the slow pace of new rules coming to the states from the federal government.

“What happens in three years?” Long queried when asked why Indiana wouldn’t opt in for the three years when the federal government picks up 100 percent of the cost. “You continue to see reports of the costs of this program going way above what they were. How are you going to pay for that?”

I asked Long about the scenario that Republican House Public Health Chairman Ed Clere, R-New Albany, raised earlier this month: The factory worker father and the retail clerk mother who stay off welfare, but have little or no health coverage. A catastrophic health event bankrupts them.

“That’s a tough question, but I don’t think it’s unfair,” Long answered. “That’s why people say we’ve got to take a look at it. To jump into the pool right now, without a better idea, is something we have to be very cautious of. I’m not saying never, either. We don’t have enough answers.”

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