Quack Quack

If it walks like a duck and quacks like a duck but the Governor says it’s a chicken…it’s Medicaid expansion!

On Tuesday, the Pence Administration announced that the federal government had approved the Governor’s “It’s not Medicaid It’s Healthy Indiana” plan to provide health insurance to additional numbers of Hoosiers. As Talking Points Memo noted,

Indiana Gov. Mike Pence (R) agreed to expand Medicaid under Obamacare Tuesday, but you’d be forgiven for not catching that if you actually listened to what he had to say.

TPM noted that Indiana’s expansion was announced with much the same terminology as expansions in other states headed by Republican governors.

The emphasis is always on the “alternative” and “unique” elements of their expansion plans. To be fair, that’s true. Starting with Arkansas, which proposed using Medicaid dollars to pay for private coverage, states with conservatives in positions of power have pushed the Obama administration to accept a wider and wider range of alternative plans that are more palatable to Republicans.

They’ve branded those plans with names like Healthy Indiana or Healthy Utah. But that doesn’t change the fact that these are proposals authorized under and paid for by Obamacare…..

The article included carefully wordsmithed statements from several other Republican states that have expanded Medicaid while denying that they were doing so.

But Pence might have been the boldest yet. His office effectively portrayed his state’s plan as a blow to Medicaid and government-funded health care.

“With this approval, Indiana will end traditional Medicaid for all non-disabled Hoosiers between 19 and 64,” Pence’s office said, “and will continue to offer the first-ever consumer-driven health care plan for a low-income population.”

But despite all of those linguistic gymnastics, astute observers on the conservative side still recognized Pence’s plan, like others before it, for what it was.

Linguistics aside, Pence might have gotten some decent publicity for his Medicaid expansion, which (whatever he wants to call it) is welcome news, and will make coverage available to many more Hoosiers– but the Administration’s ham-handed, tone-deaf effort to create a state-run news service (called “Pravda on the Plains” by the Daily Beast) sucked all the air from the news cycle, and eclipsed the announcement.

He got national attention, all right, but it wasn’t for Healthy Indiana.

Hint: Governor, if you are going to provide us with our news coverage, you need to learn how not to “step on the lede.”


  1. Then why are more of my senior friends losing their Medicaid assistance with Medicare? I’m sure Pence’s explanation will be on Just IN as a headliner.

  2. Well, can you blame Pence. God forbid, Indiana would be considered one of those states that’s part of a nation of people who want to help our sick and our poor. God save this state from being ruined by a Kenyan, Muslim, Socialist with a secret plan to confiscate our guns and our coal. Vote for me!

  3. Are we sure this was a true and accurate press release? We don’t want anymore “deflated- type” press releases. Sheila-you best check the fine print. Remember he gave away all that education money to everyone else. Is he credible?

  4. Republicans invented Obamacare in Massachusetts. When Obama proposed adopting a similar national plan Republicans labeled it “Obamacare” because they were used to their ideas failing so thought it would too, and thought that their most hated word, “Obama”, would get flushed with it.

    When it succeeded they found that what had failed was their labeling the plan “Obamacare” and what had succeeded was the plan itself.

    Oh dear.

    Now they are hard at work implementing the state level responsibilities of Obamacare but labeling them in a way that they take credit for not only their original work but the naming rights.

    If you are bulimic and want to make yourself sick think of how great the country would be now be in the absence of business like frivolous competition by the Great Oligarchy Plot with The Democrat Party.

    Remember when the two parties were different sides of the same coin? Now we’re down to one political party and one business.

    The best global examples of one party politics are Communist countries. The basis of Communism is really running countries as businesses with corporate hierarchical organizational structures and ownership of the means of production.

    The differences then between Communism and oligarchy is……….ah……….perhaps……gee. Ideas anyone?

  5. I can only assume applicants cannot apply for ACA in Indiana – and probably other Republican states with their own health care system – unless and until they have been denied by ALL providers in the state system due to some loophole in States Rights. Anyone out there have an answers for this?

  6. (The differences then between Communism and oligarchy is……….ah……….perhaps……gee. Ideas anyone?)

    The Trickle down theory ?

    Oligarchy, the wealthy 1% gets all of the money.
    Communism, the top dogs of the Party get all of the money.

    hmmmmm … definitely a similar pattern

  7. I first learned of the Medicaid addition from my husband who’s a Clinical Director, meaning that he does not teach academic courses in a traditional classroom, but rather is responsible for one module in Clinical Sciences at IUSD. All IUSD faculty members working in any Clinical Science were requested to complete the mandatory Medicaid paperwork authorizing them to receive payment (IU, not the individual doctors) for providing services to Medicaid patients. Until a week or so ago, Medicaid was not accepted by IU for dental or medical services received in an on-site IU Teaching Clinic where 3rd and 4th year students provide the services, under the close supervision of a state licensed dentist or oral surgeon.

    By the way, the following Clinical Services Modules depend upon patients, not dummies, but real patients: Comprehensive Dentistry, Operative Dentistry, Endodontics, Periodontics, Fixed Partial Prosthodontics, Removable Partial Dentures, Complete Dentures, Oral Surgery, and Implant Dentistry.

    Sure enough, the IUSD website reflects the new change.https://www.dentistry.iu.edu/index.php/patient-services/fees-insurance-medicaid/

  8. While on the subject of Medicaid being recognized by the IU School of Dentistry, this opens an opportunity for financially-strapped people with a missing tooth or teeth, especially missing teeth visible when smiling, even a small smile. According to a news article from 2012 here in Indiana, the ACLU took on the case of a female Medicaid patient whose general dentist had recommended dental implants in her treatment plan to replace her inadequate dentures; however, upon research it was learned by both the dentist and the patient that in 2012 Indiana Medicaid only approved dental procedures of less than $1000 per year which might be adequate for a couple of dental visits, prophylaxis treatments (cleaning), and a couple of small uncomplicated fillings on an annual basis.

    A single dental implant in the Central Indiana area usually costs in the neighborhood of $2000, because it requires several visits to the trained Oral Surgeon’s office, involved x-rays to determine the bone density, and a few follow-up visits. A dental implant can cost more in other areas and especially can cost more if bone density is sub-par requiring bone grafting. Amazingly enough, the procedure itself is painless after receiving the usual novacaine type injection, and the end result is remarkable.

    Here’s the article referenced above: http://indianapublicmedia.org/news/court-affirms-injunction-medicaid-dental-care-cap-36905/

  9. I’ve known for a year that Medicaid would be expanded in Indiana. The only reason it took so long was that Pence wanted to get some concessions from the Feds so that he could attempt to claim that he won the battle and got his way (which didn’t actually happen).

    The hospital executives in Indiana demanded this expansion because they could not continue to eat the losses from uninsured patients. Even though his tea party supporters fought it, Pence was backed into a corner and had no alternative.

    As we all know, the number of uninsured people in Indiana has contined to grow with high unemployment and underemployment. Far too many people earning minimum wage have been forced to pay taxes to cover people on Medicare and Medicaid, while not being able to afford insurance or even basic health care for themselves. I’ve felt for a very long time that this is nothing short of criminal robbery. People that are working very hard and can’t even pay for the cost of their basic living expenses should not be forced to pay taxes just to provide benefits to millions of wealthy senior citizens on Medicare.

    While I realize that there are millions of senior citizens on Medicare that absolutely need it and cannot afford to pay for private insurance, I do not believe that Medicare should be a given if someone never paid a penny of taxes into the system. There are only two rules to qualify for Medicare: you must be 65 and a citizen of the U.S. There are also many, many exceptions to these two rules that allows millions more into the system, but the bottom line is that you never had to pay a penny in taxes to qualify for this absolutely wonderful health insurance.

    Medicare is still better insurance than Medicaid and I believe that we should all be covered by Medicare. Universal health care would be fair to everyone and would cost providers less money to process claims. No more insurance company negotiations for a variety of discounts, a LOT less paperwork, the same regulations for everyone, bills would be sent to one place, etc, etc, etc.

    What do others think about this?

  10. Nancy; Medicare is not “given” to anyone. $99.90 is deducted from my Social Security check each and every month. When on Social Security Disability, you do not qualify for the option of Medicare till you have been on Disability for 2 years – this left me and hundreds of thousands of other Americans disabled and with no health care unless we qualified for Medicaid. I did not qualify because of a $159 monthly retirement check in addition to my $589 Social Security Disability check. Any additional income disqualifies you for Medicaid assistance when qualified for Social Security Disability. My son was rear-ended on the highway, resulting in 7 fractured vertibrae and permant disability. Almost 2 years later his attorney qualified him for Medicaid who diagnosed him as also having terminal cancer. Fifteen months later he received his first Social Security Disability check for $1,490 monthly, 5 days later he received notice he received his cancellation notice for Medicaid due to his income being too high. My letter to Michelle Obama was forwarded to his area Medicaid/Medicare office who sent me a letter and form for him to apply for Medically Needy Assistance through Medicaid. He would have been qualified if he had spent $1,210 every month for medical care from his $1,495 SS Disability check and a small percentage of his medical bills would be paid. Back to no medical care for 2 years till he qualified for Medicare; 15 months later he was found dead in his home from the cancer.

    Medicaid and Medicare are two separate entities; qualifying for either – or both in some instances – is not readily handed over. Disabled and seniors only qualify for Medicaid (state assistance) with Medicare when their monthly Social Security checks are poverty level or below. These are the people who have lost their Medicaid assistance and their food stamps. Many who have lost or are losing Medicaid assistance for Medicare will not be able to pay for Medicare and will lose medical care.

    My daughter-in-law, a janitor in a church and school, pays $450 montly for family plan health care; it has a $9,600 annual deductible, her husband is a brick mason which is seasonal and they have three children. Being forced by the state of Indiana to apply through the state health care system and must be denied by all providers before you can apply to ACA, hoping for better coverage, she applied in October 2013. At the end of June 2014 she was FINALLY notifed that she qualified for a policy costing $1,200 monthly with an annual deductible of $12,000 – she opted to reapply for her original coverage.

    What do you think of this?

  11. Nancy; quoting from the Star article, “Feds OK Pence Plan”, what was OKed expanded Indiana’s OWN BRAND OF MEDICAID which is part of this state’s Republican health care system. “It goes beyond standard Medicaid expansion by requiring that participants contribute to the cost of their care.” Per Pence, “HIP 2.0 is not intended to be a long-term entitlement program. It’s intended to be a safety net that aligns incentives with human aspirations.” I read this to be another form of his statement regarding “enobling” people with jobs when he told the jobless to find work along with ending food stamps to people who are not working. As for it being considered an “entitlement”, many of the tax dollars in this system were paid by those seeking assistance at this time due to being jobless.

    Of course those who are working should pay what they can; what he and Daniels and the current GOP do not understand is that there are millions in this country without jobs, without income, without food, without health care, losing their homes and much of the blame rests with them because they refuse to pass job creation bills and won’t come up with their own solutions. Hard as they continue to fight ACA; they refuse to acknowledge that major parts of it were written by Republicans during the Bush administration and it didn’t pass at that time. The GOP named the ACA “Obamacare” to draw attention from this fact.

  12. JoAnn, I understand what you’re saying. Three years ago when I first qualified for Medicare insurance, approximately $104 monthly was deducted from my Social Security direct deposit, which by the way, is SS I opted to receive via my late husband’s SS contributions which doubled mine as a public school educator. I’ve no idea where my personal SS contributions throughout the years as a public school educator went, perhaps they’re floating around in cyber space and drawing compound interest, but nonetheless I gave them away upon my CPA’s recommendation and decided to use my option as a survivor/a widow from my late husband’s contributions. Helpful hint: If you’re a widow or widower and remarry after age 62, you’re still eligible to receive your late spouse’s benefits if you elect.

    Big surprise a few weeks ago, a letter from Social Security Administration advising me that the deduction for Medicare has increased to $206 per month. This increase will not cause me financial distress, but it certainly was a surprise. Along with the $206 for Medicare, there’s the Advantage Health Care Solutions monthly payment of approximately $130 per month, so at present my health insurance basically costs more monthly than I ever paid when I was employed in a public school district and enrolled in its group policy. Because my husband’s health insurance is exactly the same as mine, we now have $672 per month leaving our budget for insurance purposes before the co-payments for office visits and prescription medications. I’m not whining, I can afford it, but like you mentioned, it’s not free, is it?

    Just yesterday, a young local plumber, early 30’s, who owns his own business and has one employee visited my house to replace a leaking 80 gallon water heater and during our discussion, he mentioned that he now had no health insurance for his small family and for his sole employee because he simply couldn’t afford it. He’d opted to pay the fine or tax, whatever it’s called, for not having insurance and for not providing his employee with insurance, and he’d just learned that he’d need to pay over $1500 to the IRS. All I could tell him was that at least the check I gave him for the new water heater and its installation was exactly $1500, and perhaps the leaking water heater was an answer to his current problem.

  13. Barbara; I don’t whine (whine is not the same as bitching:) about my low ($809) monthly Social Security check because my retirement ($277.62) means I can eat and buy medication; many thousands cannot. My daughter was so near death a few weeks ago due to liver disease and final stage failure, that Eskenazi hospital found someone to pay her $700 PER PILL co-pay for $1,152.58 PER PILL medication. To me, this is unconscionable and there is no guarantee this medication will save her life or keep her with us much longer. No idea what your religion is and, please understand that being a Christian it is a complement to say your attitude with that young plumber is the epitomy of Christianity. Thank you

    With all of my complaints about the Republicans; and Sheila will understand this, it is thanks to a great Republican, Mayor Bill Hudnut, that I have that retirement check. One year, in lieu of a raise to City employees, he met our 2% monthly PERF payments with equal amount. When I became disabled at age 57, my retirement was considered Hardship Retirement; I had to draw out all I had paid into PERF to live on with no income. The 2% paid in lieu of a raise could not be withdrawn but was available to me monthly as soon as my SS Disability was approved; otherwise I would have been forced to wait till age 65. Thanks to one fine Republican and a wonderful man, Mayor Bill Hudnut, I have been able to support myself the past 21 years.

  14. JoAnn, I am very sorry to hear about the health issues that you and two of your children have endured.

    We have absolutely awful access to health insurance coverage in this country. I experienced being without health insurance for a period of four years and went without necessary health care because it was just too expensive. When I looked into obtaining health insurance in the private market, it was completely out of reach. Even though they had access to my complete medical record (which showed excellent health for my age), I was told that my premiums would be based upon the average health status of people in my zip code. Seriously??? Yes, I was going to be charged as if I had terminal cancer, diabetes, and serious life-threatening heart conditions and every other poor health condition they could come up with for residents in my zip code.

    Back to my statement about free Medicare. Part A actually is free. A small premium to cover Part B is deducted from monthly SS checks. Of course, if people qualify for Medicaid the cost is even lower or nothing at all. I hope you will agree that your monthly Part B premium of $99 is wonderful for what it covers. Part B premiums are also highly subsidized by taxpayers.

    Most people on Medicare pay a premium of $104.90 for Part B insurance with an annual deductible of $147. Again, this is a great price with a very low deductible for the coverage. Regarding Barbara’s comments about her premium increase this year – part of the ACA has required a an income related adjustment in premiums based upon actual ajdusted gross income. This can change annually. If your adj gross income is between $85K and $107K the premium increased to $146.90. This is still a small premium. If your income is between $107K and $160K the premium is $209.80. A very small price to pay with this income range. The premium continues with minimal increases as income increases.

    Getting back to my statement about hard working taxpayers covering the cost of Medicare health insurance for wealthy citizens when they can’t afford coverage for themselves. I have never had the luxury of earning between $107K and $160K so I can’t even imagine having that kind of income in retirement. I consider people with this level of retirement income to be wealthy or at the very least well-to-do.

    I believe everyone in our country should have access to free Medicare Part A coverage and to Medicare Part B coverage with the same low premiums that are enjoyed by today’s retirees. And the Part B premiums should be adjusted up or down depending on individual or family income.

    We will eventually get to universal health insurance some day. Hopefully sooner rather than later.

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