Indiana Must Decide On Voluntary Medicaid Expansion

Next Governor, Legislature Will Decide

While the U.S. Congress keeps fighting about the health care law, state governments are debating whether to fully participate.

The U.S. Supreme Court decision upholding the law gave states one important out involving Medicaid.

State governments must decide by next year whether to participate in a major expansion of the program.

Advocates for low-income Hoosiers said it would give health care coverage to many people who don't have it.

But Gov. Mitch Daniels has been saying for three years that Hoosier taxpayers can't afford it.

Voluntarily expanding Medicaid would be an expensive decision for Indiana.

Daniels said he will leave the decision to his successor and a new General Assembly.

"That'll be a decision for future legislators,” he said after the court’s decision on June 28. “It's a $2 billion-plus cost to do what the federal government tried to order Indiana to do. And so that'll be a big decision."

According to a report commissioned by the state, a full expansion would increase the number of Indiana Medicaid participants in 2019 from more than 1.2 million to more than 1.8 million.

And the total cost would be nearly $3.9 billion a year, although the federal government would pay more than 85 percent.

Health care advocate John Cardwell said not expanding Medicaid will cause the state to lose a huge amount of federal money and hurt low-income people who currently make too much to qualify for Medicaid coverage.

Senate President Pro Tem David Long, R-Fort Wayne, said Indiana will almost certainly not join the expansion.

But Democrats said lawmakers should ignore the politics.

"And I'm hoping that both houses will do that, look at it for what is good for Indiana versus the politics of it," said Rep. Charlie Brown, D-Gary.

And federal officials said it's a good deal for states.

"The federal government, basically, is paying 100 percent of the first several years and then gradually picking up a share of at least 90 percent," said Health and Human Services Secretary Kathleen Sebelius.

Legislative Republicans seem solidly against the expansion, however.

Senate Appropriations Committee Chairman Luke Kenley, R-Noblesville, said joining the expansion would mean cutting funding for schools, higher education and just about everything else.

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