News and Tribune

May 22, 2013

ANDERSON: The Health Care Reform Act: Some facts to ponder

Local columnist

The Health Care Reform Act — also known as Obamacare — has drawn some lines in the sand. Why? 

As a social worker and an activist, I have witnessed the horror of a lack of medical insurance on individuals and families. I have helped to bury people who died too early and who did not know how to fight for their right to life — many discharged early from local hospitals due to a lack of insurance. 

While not the official reason listed, lack of coverage did play a role because often the doctors expressed concern. I personally heard the following words in two cases — doctors who in disgust said, “I don’t think you should be leaving but it’s not up to me, you don’t have any insurance.” 

I won’t mention the hospitals or their locations, but it happens every day.

Today, I was taking a class in water aerobics and overheard a conversation about “Obamacare.” I heard more than I could tolerate without butting in and asked how the gentlemen thought it would hurt us. His reply was that it already was. 

“How?” I asked. “I am paying more for my premiums,” he said. I then reminded him that most of Obama Care wouldn’t even begin until July 2014. It seems he understood insurance companies were upping the ante now in anticipation of “what is going to happen.” Hence this column. I Google searched and asked a question: “What will happen if Indiana doesn’t expand Medicaid?” There were pages of responses, and none good.

There is a simple understanding of how our tax dollars work. We pay them and the government spends them. If we opt out, then our tax dollars should go down because we aren’t participating. In this case, that’s wrong. 

Our tax dollars will go to other states for their Medicaid expansion and our state will lose $26 billion dollars by 2020. Those federal tax dollars won’t go down; they will merely go somewhere else. Our dollars need to help our people. It is as simple as that. Without Medicaid expansion, here are some of the ramifications:

1. $26 billion federal tax dollars will be lost to our state over the next seven years.

2. Our tax dollars will go to other states that do expand Medicaid coverage.

3. It will drive up premiums for Hoosiers with private insurance.

4. It will cost some Indiana employers hundreds of thousands of dollars in additional federal taxes after 2014.

5. Thousands of health care jobs will be threatened and could lead Indiana hospitals — especially safety-net hospitals in urban and rural counties — to reduce services and even close.

6. 40,000 Hoosiers enrolled in the Healthy Indiana Plan will lose their coverage.

7. Hundreds of thousands of the most vulnerable of our fellow Hoosiers, most of them from working, low-income families, will have no way to get health insurance. See cover Indiana (

Every federal tax dollar we send to the government has what is called a prorate share and a portion of it is dedicated back to the state. The formula changes according to the program. 

Indiana rarely takes complete, if any, advantage of this fact and as a result has historically given millions of federal tax dollars to other states because we don’t want the federal regulations. 

That is our money. It should help our people.

Every day, crowded emergency rooms are the answer to a lack of medical insurance, the Family Health Center is constantly full and people are rationing their medicines and doing without seeing the doctor until it is almost too late. 

If we talk of the effect of not accepting the Medicaid expansion, we must also discuss the benefits of acceptance:

1. Stimulates the economy by bringing billions of new federal dollars between now and 2020.

2. The federal government will pay 100 percent of the health care costs for the expansion for the first three years, and no less than 90 percent of those costs in the future.

3. Providing health insurance coverage to many more Hoosiers will reduce costs for employers and individuals who currently pay for the uninsured through cost-shifting that results in higher premiums for everyone.

4. If Indiana does not take advantage of this federal money, our tax dollars will go to other states that do expand. In other words, we’ll be taking care of everybody’s backyard but our own.

5. Approximately 880,000 Hoosiers under the age of 65 do not have health insurance, with the expansion over half (roughly 450,000) will have access to health insurance coverage if we expand the coverage.

6. This will allow a single adult with income of up to $15,415 or a family of three with income up to $26,344 to gain coverage. 

My thoughts are racing with just these facts. Why are we willing to allow our state officials to make decisions that will negatively affect our lives without flooding them with phone calls? I say again: Our legislators work for us, not for the governor, who by the way, works for us as well. 

If we choose to make decisions, it shouldn’t be on sound bites. The fact is the Health Care Reform Bill is law and until it isn’t, we should take full advantage of it. We certainly shouldn’t be throwing our tax dollars to Kentucky, New York, Vermont or any other state that has agreed to Medicaid expansion. 

We should take care of Hoosiers first. It is about time that the people of this state become the top priority. We cannot have a healthy economy or a healthy community without healthy people.


— Barbara Anderson is a Jeffersonville resident and executive director of Haven House Services Inc. Reach her at