The debate over health care reform has shifted from Washington, D.C. to the states and, here in Indiana, some Democrats are already getting frustrated.
Two major portions of the Obama health care plan require a decision from state government. One of them involves the option to create an online health insurance marketplace known as an exchange. GOP Governor Mike Pence has already decided to leave that to the federal government.
The other is an expansion of the medicaid program. If the state chooses to expand medicaid 400,000 low income Indiana residents would join the ranks of those who have access to medical care. State lawmakers in the Republican majorities, including budget writer Dr. Tim Brown, say they are considering it despite a price tag that could top $50 million dollars. “I think right now that we need to look at it, says Rep. Brown (R-Crawfordsville.) “I’m not totally against it.”
Democrats are impatient. They say federal matching funds and growth in the health care system would make up for the investment, and at a Wednesday new conference accused Republicans of avoiding the medicaid expansion for political reasons. “The Affordable Care Act is here and it’s here to stay,” said Rep. Charlie Brown (D-Gary.) “We need to stop ignoring it or running away from it because it is there. It is the law.”
“We need local control,” said Sen. Karen Tallian (D-Portage,) “and participation in this is inevitable.”
Answering questions after his first Cabinet meeting, Governor Mike Pence said he’s open to a medicaid expansion but also said it’s up to the legislature. “My bias going forward,” he said, “is any expansion of medicaid would have to be fiscally responsible.” And Sen. Pat Miller (R-Indianapolis) says it’s too soon to know whether it’s a responsible move. She said she is waiting for more information. “I can also tell you the federal government is now sending out many, many rules daily for is to comply with,” she said, “and we just haven’t had a chance to digest all that information yet.”
One option that Republicans are considering is to continue to wait. Some of them think it makes sense to let other states adopt health care reform first, work out the bugs, and then join in later.
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