By John Krull
TheStatehouseFile.com
INDIANAPOLIS – The confused response to Indiana Gov. Mike Pence’s proposed plan to expand the state’s medical coverage for the poor shows how much Obamacare has changed the American political dialogue – and is likely to continue changing it.
John Krull, publisher, TheStatehouseFile.com
John Krull, publisher, TheStatehouseFile.com
Pence, a conservative Republican whose flirtation with running for president in 2016 has elevated his national profile, announced May 15 that he wanted to expand the Healthy Indiana Plan – HIP – so that it would provide health coverage to an additional 350,000 Hoosiers.
Commentary button in JPG – no shadowPence and other conservatives tout HIP as a market-driven answer to Medicaid. Perhaps the biggest difference between HIP and Medicaid is that HIP requires the poor to have “some skin in the game,†to use Pence’s phrase, by paying a nominal fee for the coverage. If the poor don’t have any skin to spare, they get shifted to another, more basic plan.
Because the Indiana governor has been such a loud and persistent critic of President Obama’s health care reform efforts – and because his contemplation of a presidential run has been about as subtle as a Madonna concert’s allusions to sex – Pence’s proposal drew national attention.
Curiously, though, neither the criticism nor the praise seemed to be defined along partisan lines.
Forbes magazine and the conservative think tank the Heritage Foundation labeled Pence’s plan a mistake and said the Hoosier governor should walk away from Obamacare in all forms. The Washington Times, a conservative newspaper, praised Pence for coming up with a GOP-friendly alternative to Obamacare.
On the other side, The New York Times and The Washington Post saw Pence’s proposal as a sign that yet another GOP governor was quietly acknowledging reality and softening his opposition to Obamacare.
Still others made the argument that distinguishing between HIP and Medicaid was the same as establishing a distinction without much of a difference.
There doubtless is some truth to all of these arguments, but they all, to a certain degree, miss the most important point.
And that is that the president’s health care reform package has challenged everyone, Republican and Democrat alike, to think anew about how we provide medical care and how we pay for it.
I remember a conversation I had with a couple of doctors a year ago, not long after the president’s second inauguration.
Neither doctor was a fan of either the president or, in its particulars, Obamacare. Both men emphasized that they’d voted for Mitt Romney.
But they also both said that the president’s health care reform plan had done one essential thing. It had forced a national conversation about health, about costs and how about how we deliver medical care.
“I have to give Obama credit for that,†one doctor told me. “He made health care something politicians had to confront instead of something they struggled to avoid dealing with.â€
The doctor was right.
If the federal government approves Pence’s proposed HIP expansion, it will extend health-care coverage to 350,000 Hoosiers.
But those 350,000 Hoosiers without meaningful health coverage didn’t just suddenly appear. They have been here for decades – along with 30 million to 40 million other Americans who didn’t have health insurance and for whom a major or lingering illness was an economic disaster in waiting.
Republicans such as Pence fought Obamacare with ferocity from the beginning, but their efforts to derail the president’s plan faltered in large part because they never advanced their own plan to meet the needs of those 30 million to 40 million citizens. They lost the national debate over health care because they offered only criticism, not an argument or an alternative.
Because Obamacare is likely to be an enduring reality – and because the enrollment and financial numbers for the program show it isn’t the disaster Republicans banked on it being – conservatives such as Pence now are grappling with creating alternatives to and refinements of the president’s plan.
Critics can and will carp that they’re joining the discussion a little late, but better late than never.
In part because Obama did force the conversation about health care, we Hoosiers – we Americans – finally are getting what we needed from the beginning.
A debate, and not a shouting match.
John Krull is director of Franklin College’s Pulliam School of Journalism, host of “No Limits†WFYI 90.1 Indianapolis and publisher of TheStatehouseFile.com, a news website powered by Franklin College journalism students.
An article in the C&P April 23 had EVSC Superintendent David Smith stating, “Smith said the district’s health insurance costs have increased by 512 percent since 1997.”
People like Pence who have fought any form of health care reform without any solutions of their own are directly responsible for that 512 percent increase.
Welcome aboard preacher, you’ll find being part of the solution won’t leave that bad of a taste in your handlers mouths after all…………….
And United Health Group’s stock is up 1,178% since 1997 vs the S&P 500 which is up 688% during the same time period.
Question: Does this new version of HIP have dental coverage? The first HIP did not. What a huge problem that is!! I know this from personal experience dealing with dental patients.
“The first part of the “Healthy Indiana Plan 2.0” would allow adults earning less than 138 percent of the federal poverty level to enroll in the state’s hybrid health savings account plan. If the residents pay a small monthly fee, they would be enrolled in “HIP Plus,” which provides dental and vision coverage, as well as better prescription coverage. If residents miss their payments, they would drop down to “HIP Basic,” which does not include vision and dental coverage and other “extras”.
Thanks for answering my first question. Now another: What is the federal poverty level and is the new HIP program open to all who qualify or only a limited number of individuals?
This is the present poverty level Martha:
2014 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES
AND THE DISTRICT OF COLUMBIA
Persons in family/household Poverty guideline
For families/households with more than 8 persons, add $4,060 for each additional person.
1 $11,670
2 15,730
3 19,790
4 23,850
5 27,910
6 31,970
7 36,030
8 40,090
138% of the poverty level I believe would be around $16,000 for a household of 1 and around $33,000 for a household of 4.
Pence’s solution should cover everyone ObamaCare would have which as Bandana stated he deserves credit for.
Pence’s proposal makes people a bit more responsible for making the system work.
I hope it works…..
I don’t think Pence could afford to not do something like this. The governors who unapologetically refuse to expand Medicaid in their states for partisan reasons, leaving the money that would have gone to assure some level of health care for their uninsured people to be distributed to other states, will pay a price for their intransigence.
Pence made a reasonable move and should get credit for it.
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