It was, after all, only the second time an Indiana governor had visited the Neighborhood Health Clinics Inc., so the small group that awaited Mike Pence on Tuesday morning was excited about the chance to show him around. Not every community has a facility that’s been providing health care to people regardless of their ability to pay for 45 years.
Also auspicious on the rare bright spring morning was a sense that perhaps an impasse between Indiana and the federal government on expanding Medicaid may soon be broken. President and CEO Mary Haupert said she was hopeful about an end to the stalemate, which has left in limbo as many as 400,000 Hoosiers who make too much to qualify for Medicaid and are too poor for Affordable Care Act tax credits.
The NHCI staff sees them every day. Though anyone can become a patient, almost three-fourths of the clinics’ clients walk in the door uninsured. The people that we treat are people who have jobs. They’re working without insurance, Haupert said. They’re not all the poorest of the poor.
Backed by private, state and federal funding, NHCI is able to charge such patients on a sliding scale, so no one is turned away. The uninsured are also helped to apply for Medicaid or to join the waiting list for the Healthy Indiana Plan, which now covers about 45,000 Hoosiers.
Expanded Medicaid coverage, as offered to states as part of Obamacare, would have helped community medical centers like NHCI and benefited individuals who don’t have ready access to such centers or need elective surgery or other types of treatment beyond the primary care NHCI offers.
Indiana, though, declined the Medicaid-expansion option last year. The hope for expanded coverage in 2015 is based on talks the state and federal government are having that might allow Indiana to replace Medicaid with a greatly enlarged version of HIP that could be offered to Hoosiers in the gap.
Pence’s words in Fort Wayne on Tuesday did nothing to discourage the hope.
After the governor and his entourage had toured the NHCI facility, Pence sat in a conference room and listened as board members, some of whom began as clinic patients and staffers, talked about the plight of the poor.
We’re hard-working folks trying to do our best, board chairman Terry Broberg-Swangin told Pence. But sometimes it’s hard to make ends meet. Broberg-Swangin recalled a time when she told her husband, Honey, I have money to get your blood pressure medicine or to pay the rent.
Pence praised NHCI and its staff and told them solving the health care challenge is on his mind every day. He said the state may be applying to the federal government within about a month for permission to pursue the expanded-HIP option in order to take care of Hoosiers the Indiana way.
I think the parties on all sides are working in very good faith, said Pence, who in the past has been a harsh critic of the Affordable Care Act and those who administer it. But we’re not there yet.
Pence said he wants to be sure any new plan preserves the consumer-driven spirit of HIP – the state program requires that patients pay a part of the bill. And, he said, I want to make sure that it’s done in a fiscally responsible way.
Though the federal government would fund the expansion’s first years, contributions by Indiana would be required by 2020.
The governor closed the informal session with a phrase that showed he at least understands what’s at stake.
A society can be judged by how it deals with the most vulnerable, Pence said. What could a group that lives that philosophy every day do but nod assent to that?