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HIP 2.0 is great, but we have a better choice

Affordable Care Act is superior, state program architect says

As someone who was in on the birth of the Healthy Indiana Plan, I suppose I should feel paternal warmth at the praise that has been heaped on the program by Gov. Mike Pence in recent weeks.

One of the core beliefs in my career as a state legislator has been that we can use the machinery of government to improve the lives of the citizens it serves.

There should be no greater example of that than ensuring that each person has the ability to live a healthy life, and that the course of that life should not have to be determined by whether or not you can afford to go to the doctor when you don’t feel well or your kids are under the weather.

From the start, I have felt that we deserve universal health care. It is the simplest means to deliver these services to the public, and it fulfills the moral imperative that I believe we have as a society to take care of all of us, rather than just a privileged few.

But I realize that we live in a society where many do not share that sentiment. Fortunately, there were enough people in both political parties – people like state Sen. Pat Miller from Indianapolis and, yes, our former governor, Mitch Daniels – who thought our state had to do something that Healthy Indiana was born.

Now we are told by our governor that the Healthy Indiana Plan in its newest incarnation – HIP 2.0 – is the be-all and end-all for affordable health care for the people of this state.

How I wish that were true.

Considering the intransigence our governor shows in refusing to pursue other, more sensible options, I hope it will be true.

But as one of the architects of Healthy Indiana in the 2007 session, I can tell you this program never was designed to be a be-all and end-all, and I am unsure that past performance demonstrates that a massive expansion is the way we must go to reach our ultimate goal.

You will hear the governor talk about 45,000 Hoosiers benefiting from Healthy Indiana. You will not hear him talk about the nearly 60,000 people who were kept on a waiting list to get on the program but never did.

You will not hear him talk about the $300 million that lies dormant in the Healthy Indiana Trust Fund, unused as part of a grand scheme to ensure that we keep a state budget surplus of around$2 billion.

Perhaps it is true that HIP 2.0 will provide a greater example of consumer-driven health care, as the governor claims, but I have yet to see that such sentiments were proven based on the first few years of operation of HIP.

But we live in a state where our governor seems more interested in making big, splashy pronouncements and hoping no one takes the time to look at the potentially fragile underpinnings beneath the surface.

The easiest solution would be signing on to the millions in federal dollars, our tax dollars, that come from accepting the Medicaid expansion that is part of the Affordable Care Act. A simple glance at our neighboring states will show that they gladly accept our largesse to help pay for their health care. Indeed, recent polling has shown that the percentage of uninsured Americans has dropped from 18 percent to 13.4  percent, thanks to Medicaid expansions and the creation of insurance exchanges. Some states have seen their uninsured rates cut in half.

Of course, this expansion to HIP 2.0 would not be able to take place without the governor accepting some of that “forbidden” federal funding.

But our state’s chief executive continues to disparage the ACA, hoping that we will not notice the contradiction. As seen by the disparaging remarks that have come from some of his usual acolytes, it hasn’t worked so far.

Let them snipe at each other.

My concern remains the same as expressed so many years ago: What can we do to get the best, most affordable health care to the most people in Indiana?

As one of my colleagues puts it, how can we keep from making the emergency room the primary health care option for too many people?

Right now, it would seem that HIP 2.0 is the course being traveled.

I hope they are right, but I worry that we are too bull-headed to see that a better solution lies right in front of us.

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