News and Tribune

June 17, 2013

HOWEY: Who’s caring for Hoosier kids outside the womb?

By BRIAN HOWEY
Indiana columnist

NASHVILLE, Ind. —

Let’s talk about Hoosier children.

Five readings this past week really popped out.

The first was a Feed America study in 21 counties in Central Indiana that revealed that only a daily basis, 320,000 Hoosiers — including 100,000 kids —don’t know where their next meal will come from. Or as Gleaners Food Bank observes, 15.2 percent of this population “struggles with hunger.”

The second was my colleague Maureen Hayden’s report for Community Newspapers, which revealed that while 17 percent of Hoosier kids live in poverty, 49 percent are on the school free lunch program. She reported that there is “no proof of income required.” Two things are going on here. Some parents are gaming the system, and school corporations get extra money based on how many kids are in the lunch program. There are $6 billion state dollars that go into K-12 schools and about $1 billion is tied directly to this “complexity index” which includes the free lunches.

Three, a Harvard and City University of New York study of Indiana reveals that 232,000 Hoosiers  won’t get health care coverage that will be available in other states because Indiana has rejected expanding its Medicaid program. Gov. Pence is seeking a federal waiver to do this through the Healthy Indiana Plan, which covers about 40,000 Hoosiers, with a similar amount on a waiting list. The Indianapolis Business Journal reported that there were 764,000 uninsured Hoosiers (12 percent) before the implementation of the Affordable Care Act or “Obamacare.” Expansion of Medicaid would cut that number to about 6 percent of the population. But if Indiana does not expand Medicaid coverage, the IBJ reports, its uninsured population will remain at nearly 10 percent. It’s that difference of 4 percent that could impact 232,000 people. 

Then there was the RAND Corporation study of 14 states (not including Indiana) which have opted not to expand Medicaid. It reported: Those state governments collectively will spend $1 billion more on uncompensated care in 2016 than they would if Medicaid is expanded. In addition, those 14 state governments would forgo $8.4 billion annually in federal payments and an additional 3.6 million people will be left uninsured.

“Our analysis shows it’s in the best economic interests of states to expand Medicaid under the terms of the federal Affordable Care Act,” said Carter Price, the study’s lead author and a mathematician at RAND. “States that do not expand Medicaid will not receive the full benefit of the savings that will result from providing less uncompensated care,” Price said. “These states will still be subject to the taxes, fees and other revenue provisions of the ACA, without reaping the benefit of te additional federal spending which will costs those states economically.” 

The increased coverage is expected to reduce uncompensated medical care by $18.1 billion. “State policymakers should be aware that if they do not expand Medicaid, fewer people will have health insurance, and that will trigger higher state and local spending for uncompensated medical care,” Price said. “Choosing to not expand Medicaid may turn out to be the more-costly path for state and local governments.”

Finally, there was a Howey Politics Indiana column by Craig Dunn, who chairs the Howard County Republican Party. He writes: “This column is directed at pro-life advocates in our government who are under the lamentable belief that the issue stops at the point of birth. They seem to labor under a thought process that says, “If you have an unwanted pregnancy, have the baby.” 

“If you have been told that you will have a baby with congenital birth defects, have the baby. If you’ve been raped and are pregnant, have the baby.” Then, when the baby arrives, their attitude transforms to, “It’s your problem, deal with it!” 

Dunn, who is a conservative and an ardent Obamacare opponent, continued: Politicians postulate all of the time about creating environments for success. They talk about creating a tax structure that will make our state more attractive for business development and expansion.  They build sports stadiums and induce professional teams to locate in them in an effort to make their community “world class.”  They spend to build jogging paths, bike trails, swimming pools, concert halls and parks to improve the “quality of life” for their citizens. 

Dunn lives in a state that just cut corporate and financial institution taxes, spent $26 million on casinos, but then cut infant and toddler programs.

“What about the ‘quality of life’ for the newly born child with a birth defect or disability, the mother struggling to find childcare so she can work, the mentally or physically impaired adult who has lost their support system or the couple struggling through the expensive morass of the adoption process?” Dunn asks. “I believe that many well-meaning politicians care more about the quality of life in the womb than the quality of life after birth. It is a problem that must be addressed.”

Folks, there are great complexities in all of these issues. It takes a pragmatic approach, whereas the ideologues in power cling to the black and white and ignore the gathering and festering gray areas.

Who will be the guardians of our Hoosier children?

— This columnist publishes at www.howeypolitics.com. Find him on Twitter @hwypol.