INDIANAPOLIS - There is a new battle over the federal health care act at the Statehouse.
Gov. Mike Pence and legislative Republicans insist that expanding the Medicaid program, as the law encourages states to do, would be a bad deal for Indiana taxpayers, but Democrats say it would benefit the state financially, in addition to helping more Hoosiers who can't afford their medical care.
Pence says Indiana wants no part of the Medicaid expansion because it would cost taxpayers here too much money -- more than $2 billion over the next seven years -- even with Washington picking up the bulk of the cost.
Senate leader David Long says the expansion would push the state into a tax increase.
"Even taking the tobacco money and including that into our expansion of Medicaid, we'd still be about a billion-five in the hole by 2020," Long said. "There's no other way to get that money but a tax increase."
Republicans also charge that Medicaid is a flawed program, rife with inefficiency, delays and bureaucracy, but Democrats who tried unsuccessfully to get the Senate to go on record in favor of the expansion feel exactly the opposite.
"I can tell you a lot of the constituents in my district that receive Medicaid assistance are very grateful," said Sen. Jean Breaux, D-Indianapolis. "And it works very well for them. So let's continue to expand what we already use, bring in those additional folks, and build out that program to meet our needs."
Pence says any expansion here would have to be based on the state's Healthy Indiana Plan, which serves low-income Hoosiers but requires user participation such as co-pays, which Medicaid doesn't.
Greatly expanding the number of HIP recipients would require federal funding for HIP, which Washington has refused to do.
Democrats say HIP is a good program, but it couldn't handle the size of the Medicaid expansion.
"There are some good components to HIP, but right now it certainly isn't significant enough," Breaux said. "We have a huge waiting list."
Many Republicans say HIP is a better program than Medicaid because making participants share in the cost makes them more frugal about using medical care, but Democrats say HIP discourages sick people from getting help, and that makes Medicaid better.