An Unhealthy Partisanship

As Hoosiers proved again last November, we’re a Red, Red State. And evidently, that partisan identity–and a deep desire to thwart that Kenyan interloper who inexplicably occupies the White House–is motivating a costly and immoral decision on healthcare.

The Affordable Care Act–aka “Obamacare”–provides incentives for states to expand Medicaid coverage. That expansion is not mandatory, however. (The Supreme Court’s decision upheld the Act, but not provisions making Medicaid expansion obligatory.)

There’s a lot of misunderstanding about Medicaid and who it covers. Currently, Indiana’s Medicaid program provides health care to about one in seven Hoosiers–mostly children, pregnant women, the disabled, seniors in long-term care and very low income families. The word “families” is key here, because non-disabled childless adults under the age of 65 are not eligible for Medicaid, no matter how poor they are. And the “eligibility” of families with children is mostly illusory: a family of three (mother, father, child) with income over $4582 a year makes too much to qualify.

The new health reform law gives Indiana the option of expanding Medicaid to provide care to Hoosiers who are currently uninsured–by increasing eligibility to low-income working adults with incomes up to 138% of the federal poverty level. Last year, that would have been $15,415 for an adult, and would have allowed that  family of three to make the princely sum of $26,344.

If Indiana opts to participate, an estimated 450,000 Hoosiers would benefit. And here’s the kicker: if Indiana does participate, the federal government will pay all the costs for the first three years. The state’s portion would then phase in gradually, topping out  at 10% in 2020.

And if we don’t participate? Well, poor people have this pesky habit of getting sick anyway. And we already pay to treat them–frequently, in the least cost-effective way, when they appear at hospital emergency rooms. When uninsured folks are treated there, the costs of their un-reimbursed care drives up the premiums of those with insurance. If the hospital is public, our taxes go up. If the hospitals still can’t recover their costs, they cut healthcare workers or reduce services. The 10% Indiana would eventually have to pay to cover far more people is unlikely to be more than we are actually paying now in a variety of ways–it would just be more visible and much more cost-effective.

The arguments against participating mainly boil down to two: the feds might change the formula sometime in the future, and we don’t like the government or the President.

Let’s see: on the one hand, the federal government will pay to cover nearly half a million Hoosiers whose lack of insurance is currently costing all of us money and jobs. On the other hand, we can show that socialist Barack Obama how much we hate him.

Even Ohio Governor John Kasich–a man without a “blue” bone in his body–has concluded that cutting off one’s nose to spite one’s face is rarely a sane public policy option.