After years of fighting for expansion of Medicare to all Americans, a single-payer system, I am now writing to the newspapers, Kathleen Sebelius of U.S. Health and Human Services and our state legislators to deny Gov. Pence’s request to expand the Healthy Indiana Plan (HIP) rather than expand Medicaid under the ACA.
I remain a single-payer supporter. I fervently believe that Medicare to cover us all would save billions and provide the most effective, efficient, equitable and quality health care. As I have stated many times before, the United States is the only Western democracy without some form of national health insurance. Germany began its national health insurance system under Bismark. But the expansion of Medicare for all is not before us now.
As we know, the heart of the Obamacare will roll out Jan. 1, 2014. The governor states we cannot afford Medicaid. I say we cannot ignore that currently 400,000 Hoosiers are without health insurance, therefore, unable to access health care other than in an emergency. HIP, on the other hand, has only covered 39,000 people. This is only 10 percent of those who would be covered by Medicaid under ACA.
HIP does not cover vision or dental care. HIP also has a very long waiting list, and for those without children, it appears impossible to become a HIP enrollee. We cannot afford to wait another year trying to adapt HIP, filing waivers and considering covering gaps. In Indiana, a person making $11.50 per day is over income for Medicaid coverage.
HIP has a monthly premium, sometimes as low as $10 or $15. However, in homes of low-wage-earners, a car repair makes the difference between getting to work or paying a premium. If a person loses his job, there is no money for the premium and HIP is lost and one must again try to enroll the next year. This is no type of service that offers a leg up to the working poor.
There certainly are ways to obtain monies for Medicaid, given the fact that under ACA, for the first years, the federal government will pay the full cost. By 2019, Indiana would be responsible for 10 percent of the cost of Medicaid in the state. We already have the money if the monies for HIP, raised by cigarette taxes, which brings in $121 million, could be used to supplement the state’s portion of Medicaid costs.
Our state’s high-risk pool, known as ICHIA, now costs the state $48 million. After 2014, it will no longer be needed when the Affordable Care Act is implemented. Those funds could be dedicated to Medicaid. Sin taxes are a good way to fund health care expansion. Sin taxes are reasonable to pay the cost of health care. Neither smoking, drinking nor gambling improves one’s health or longevity.
Other governors of Ohio, Arizona, New Jersey and Florida, all Republicans opposed to ACA, have agreed to the Medicaid expansion. Why not Gov. Pence? It is most important to move rapidly to expand Medicaid coverage as much as possible and as soon as possible. If Indiana is truly a right-to-life state, we need to start taking care of the living.