Just Give Me the Money!

We need to ask Governor Pence just what part of “accountability” he doesn’t understand.

The IBJ recently reported that the administration is refusing to give the federal government access to information about HIP 2.0–the system that he used to implement Medicaid while insisting that it WAS NOT MEDICAID, NO SIREE! Well, in all fairness, it did have differences; it covers fewer Hoosiers than a simple Medicaid expansion would have done, for one. Call it Medicaid-lite.

The plan was sufficiently in compliance with Medicaid regulations to allow the federal government to fund it–on condition that they evaluate the program after it had been in effect for a period of time. When the time came for the state to submit information needed for that evaluation, however, Pence refused to comply.

The most recent flare-up between the Pence and Obama administrations came when Indiana missed a June 17 deadline for submitting data to the federal government on who was enrolled and what kind of benefits they were receiving.

Now, maybe I’m missing something, but when the agency that is paying for a program asks for information needed to determine how you are using its money, it seems reasonable that you would comply.

But of course, the words “reasonable” and “Mike Pence” are rarely found in the same sentence. (That’s probably why Trump finds him congenial.)

Indiana officials, however, have balked for months at the federal review, saying they are conducting their own outside review.

“I am concerned that two evaluations being conducted at the same time has the potential to create contentious outcomes which can impede fair, impartial and empirical analysis of demonstration projects,” Pence wrote in December to the U.S. secretary of health and human services.

To some observers, the conflict seems to boil down to this: Pence doesn’t trust the federal government to do a fair evaluation.

Gee–if I were the federal government, I wouldn’t trust Pence to administer a fair system.

A former state official has a theory about why a simple element of accountability–a look at the books to determine whether federal funds are producing the agreed-upon results–has Mikey’s panties in a twist:

“From the beginning, when Pence established this Medicaid expansion by using HIP, he has struggled to make it look like it’s an Indiana plan, not a federal plan,” said Sally McCarty, former Indiana insurance commissioner under Democratic Gov. Frank O’Bannon, and a former senior research fellow at the Center of Health Insurance Reforms at the Georgetown University Health Policy Institute.

“He probably doesn’t want to relinquish ownership of any of it and give any control to the federal government,” McCarty said.

He just wants the money–no pesky “accountability strings” attached.

I don’t think it works that way.

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