As I’ve traveled across Indiana these past weeks, many of you have asked me about the federal health care debate. You want to know how legislation may affect us, especially those who rely on Medicaid, our HIP 2.0 program or the federal insurance exchange. You’ve asked about the potential gaps that could be created by reduced federal funding.

Last week, we saw two separate publicly reported estimates about the impacts of Senate legislation that were $5 billion apart. By tomorrow, there could be other reports with completely different numbers. As I write this, there are rumblings of a potential vote this week. The point is, no one yet knows what the final legislation will contain or whether there will even be agreement to bring a bill to a vote at all.

Here’s what I do know.

We cannot continue to ignore the problems with our nation’s current health care system. Medicaid and Medicare are shattering our federal budget, and the national debt has skyrocketed to $20 trillion. Obamacare is crumbling under its own weight. In Indiana, as many as 60 counties will be left with just one choice for insurance coverage under the Obamacare marketplace beginning in 2018. Premiums are rising, our Hoosier neighbors are losing access, and employers are frustrated by federal overregulation that makes it more difficult for Indiana to put Hoosiers to work.

Despite this dysfunction, Indiana found a way to bring health insurance coverage to over 400,000 low-income Hoosiers through our consumer driven program known as the Healthy Indiana Plan (HIP 2.0).  HIP does more than just provide insurance coverage: It encourages people to make wise decisions about their own health and health care. It helps connect Hoosiers with resources to get a job and improve their overall quality of life. Ultimately, it’s a transitional program that gives Hoosiers the support they need to eventually transition to private health insurance on their own or through an employer.

In June, when two insurance providers announced they would pull out of the Indiana Obamacare insurance exchange completely in 2018, we learned that Decatur, Jackson, Grant and Wayne counties would be left without any provider options on the federal exchange. We’ve been working since then to secure another option for Hoosiers in these counties, and I’m confident we will find one. This is another example of how states are best-positioned to solve problems for their citizens.

Indiana will not wait for Congress to resolve the ongoing national health care crisis. We have proven we will find solutions to meet Hoosier needs but we need more flexibility and control to continue HIP 2.0 and stabilize the individual insurance market. At the same time, we will work with federal leaders to find real reform that addresses the deeper problems with health care delivery and cost, not just insurance coverage.

As governor of Indiana’s 6.6 million citizens, here’s what our federal partners could do to be helpful.

First, give us greater control of federal health care dollars being spent in Indiana. From Medicaid to health exchange subsidies, billions of dollars come into our state each year, but with too many federal mandates. Let Indiana put that money to work using HIP 2.0 as the model and give us adequate time to adjust to new funding realities resulting from federal legislation. Next, work closely with our state to provide the flexibility we need to efficiently deliver services to our citizens. The federal Centers for Medicare and Medicaid Services earlier this year issued a call to the states to come to them with innovative plans and requests for flexibility. That is precisely what we are doing.

Finally, provide additional support to help us address our state’s opioid crisis. I’ve been encouraged to hear that federal legislation could include significant funding to help states address the drug epidemic. Indiana can put those resources to work immediately.

Health care will not be reformed by maintaining the status quo. That’s simply said but harder to swallow when you see the effects on individuals. I urge the Senate to continue the important work of repealing and replacing Obamacare. Fixing the root problems in our system will be difficult, but as history has shown, Indiana is well positioned to lead the way with solutions tailored to our unique population.

I have high hopes for a healthier future for all Hoosiers. This is our moment to work together with federal partners to find a health care solution.

Sincerely,

Eric J. Holcomb

Indiana Governor