Governor Pence has issued Executive Orders 14-04 and 14-05 providing for cooperation with the NFL and the NCAA respectively.

The executive order concerning the NFL is in furtherance of efforts to land Super Bowl LII and provides a commitment that Indiana will supply such things public safety, fire, and street maintenance services at no cost to the NFL or the teams playing. The State will also actively protect the NFL’s intellectual property rights — or at least that’s how I read the bit about agreeing to “actively protect against unauthorized promotional activities” for a three week period surrounding the Super Bowl.

The executive order concerning the NCAA is to host, I gather, one of the Final Fours between 2017 and 2020, and it makes similar guarantees to the NCAA and teams participating in the Final Four.

Maureen Hayden had a good column on the state of Indiana Health Care. She notes that the Healthy Indiana Plan, touted by Gov. Pence as an adequate alternative to Medicaid expansion under the Obamacare reforms, serves only 37,000 Hoosiers (with a waiting list of 55,000); leaving out 300,000 who would have been covered if Medicaid had expanded as expected.

When asked about uninsured Hoosiers:

Pence’s response was to say there was a “broad range of services” available to uninsured Hoosiers, from public clinics to hospital charity care.

“Let’s make sure there is a distinction in the language between health insurance and health care,” he said. “Every person in this state has the ability, if they are struggling with illness, to walk into an emergency room and receive care.”

In most cases, the emergency room is a wasteful place to initiate care. “A stitch in time saves nine” and all of that. I have collected hundreds, possibly thousands, of emergency room bills over the years; and they are expensive with people ill-equipped to pay them — they couldn’t afford them at the time of service, and often enough, the health condition that sent them to the ER renders them less able to work. The collection rate is well under 100% meaning that the rest of us subsidize these services in any event.

It would make much more sense to have a rational funding mechanism where we subsidize these health services explicitly and thereby allow delivery of the services in places outside the ER where better health outcomes can be had for less money. Instead, we have this ad hoc system where the subsidies are more hidden and the most expensive, least effective delivery mechanism is used.

Hayden’s column concludes:

Pence is correct: There is a safety net for the ill and uninsured. But it’s a tattered one.
. . .
“We do have access, but the health of Hoosiers is not good,” Kelso said, before listing a litany of ills that include Indiana’s high rate of diabetes, heart disease, obesity and infant mortality (which is related to lack of access to pre- and post-natal care.)

The governor’s own health commissioner, Dr. William VanNess, recently noted that an infant born in Indiana has a higher rate of dying before its first birthday than almost anywhere else in the nation. Indiana now ranks 47th out of the 50 states in infant mortality.
. . .
“We’re down near the bottom. We’re right down there with Mississippi and Arkansas in the number of babies that are dying. Think about that.”

I guess I could insert a “pro-life” quip; but that would buy into the frame of that debate — when that debate is more properly seen as being about female sexuality.

Instead, Indiana’s hang up and resulting poor health probably has more to do with a deeply held fear that people might get something for nothing. Laziness is immoral; and economic well-being signifies moral rectitude. If we give people (who, by virtue of their poverty are demonstrably lazy) free healthcare, they will lack proper incentives to work. Or something like that. Consequently, we continue to embrace a system that is as inefficient as it is destructive to the health of Hoosiers.

Rich James, writing in the Northwest Indiana Times, has a column about the Pence administration’s recent response to Gary’s request for help from the State Police.

After the mayor asked Gov. Mike Pence last month to send state troopers to the city, the governor said he would direct state police Superintendent Douglas Carter to assess Gary’s needs.

Well, the Pence patrol met last week in Lowell.

Pence told the mayor Carter’s team “will assist you in reviewing your intelligence gathering, training, command structure, budget and staffing levels.”

Apparently the meeting did not include the Lake County Sheriff, a representative from Gary, the East Chicago PD or the Hammond PD. It did, however, include representatives from the Michigan City PD, the Marion County Sheriff and the Porter County Sheriff.

I can’t imagine if Mayor Dennis had asked for help for West Lafayette which prompted a meeting that didn’t include a representative from our city but did include someone from Muncie, Wayne County, and maybe Frankfort.James suggests that the result of this process will likely be an effort to force some square pegs into round holes.

Late last week, I saw opponents of Obamacare pushing a story out of Indiana that said insurance premiums would spike 72% up to an average premium of $570/month. Not long later, I saw Aaron Carroll at the Incidental Economist cautioning against putting much stock in those numbers as we didn’t know much about what went into those averages.

Sarah Kliff, writing for the Washington Post Wonk Blog has a good explanation about why those numbers are misleading. We still don’t know what all is in those numbers, but it seems very likely that the expensive premiums in some Cadillac plans are pushing up the average and that the less generous plans are likely to have premiums that are in line with those of other states where the premium jumps don’t look all that notable.

The health-care law envisioned Americans having a choice of different levels of insurance coverage. Sick people, for example, might want to pay a higher premium for a health plan that would cover a greater chunk of their bills. Healthy individuals, conversely, could gravitate to a more bare-bones plan –- one that left them more financially vulnerable but also with a smaller premium.

These plans are categorized into metal levels. A “bronze plan,” for example, covers 60 percent of the average beneficiary’s bills and would likely have the lowest premium. A silver plan covers 70 percent, and a gold plan foots, on average, 80 percent of the bill. At the very top of the heap are platinum plans, which foot a hefty 90 percent of the average subscriber’s costs.

There’s some evidence to believe that the most important rates are the prices we should watch most closely. Those are likely the plans that buyers on the exchange will gravitate toward. We saw this in Massachusetts, where the vast majority of enrollees purchase a bronze or silver insurance plan.
. . .
We’ve seen in other states’ data that bronze plans and silver plans can have hugely different premiums. Here in the District, for example, CareFirst plans to charge a 27-year-old $172 for bronze coverage and $341 for a platinum plan.

Indiana’s $570 figure comes from squishing together all the filings –- every plan that is bronze, platinum or anywhere in between –- and coming up with one composite.

Tony Cook’s story for the Indianapolis Star reported the Pence administration’s side of things and had asked for a breakdown on the individual level plans. The deputy at the state Department of Insurance who had a political message ready to go bemoaning the fate of Hoosiers under Obamacare did not, however, have information about the different plan structure. Darn the luck.

I wasn’t especially animated by the initial revelations about then Gov. Daniels’ e-mail exchange about teaching Howard Zinn in the schools. It didn’t exactly come as a shock that Gov. Daniels didn’t like Zinn. The idea that the wealthy might be profiting from value extracted from the poor rather than enjoying the just rewards of their own contributions is counter to Gov. Daniels’ worldview.

And, getting animated about not teaching such things in school, while questionable as official government policy, also didn’t shock me because, so far as I can tell, things didn’t make it past the e-mail stage. I can confess that I’ve talked a lot of intemperate trash about an opponent’s case that never managed to find its way into a formal motion or pleading.

But, his response has prompted me to follow up on the story. Daniels told WBAA’s Mike Loizzo:

“[I] simply was inquiring about the K-12 system and asking whether this false, misleading version of American history had found its way into Indiana classrooms.”

Sounds vaguely reasonable. I’d get a little disturbed if I found my kids were being forced to memorize passages from Mao’s Little Red Book. But, it’s not quite as simple as all of that. Take a look at the e-mail exchange. He was proposing to eliminate credit hours for teachers taking classes that taught Zinn’s perspective on American history. That’s a horse of a different color. Now he’s getting closer to indoctrinating the teachers than shielding the children.

Doghouse Riley suggests that Daniels’ concern about Zinn’s “A People’s Histors” being taught as the “text book of choice in high schools and colleges” started as anti-fluoridationist hyperbole by Roger Kimball in the National Review.

From there, you have his education policy director talking smack about IU and mentioning that there was a course on the labor, civil rights, and feminist movements available for teacher continuing education credits. “Zinn along with other anti American leftist teachings are prominently featured.” Daniels responds that, “this crap should not be accepted for any credit by the state.” He follows up by suggesting a clean up in what is credit worthy in professional development. He puts “professional development” in scare quotes. He apparently deems Zinn’s work as “propaganda,” not suitable for teacher professional development classes.

So, Gov. Daniels’ insistence that he was just concerned for K-12 students looks suspect. He was directly targeting the substance of college courses in a way that would affect the substance of K-12 only indirectly.

(Via the Indiana Law Blog) Dan Carden, writing for the Northwest Indiana Times reports that the Pence administration has not been making any contingency plans for the possibility that the federal government will not approve the “Healthy Indiana” plan as a Medicaid substitute.

Readers may recall that Medicaid expansion was a key part of the health care reform effort. The Affordable Care Act would provide subsidies to those making more than 133% of the poverty level but unable to afford health insurance. The expansion of Medicaid was designed to cover those not currently eligible for Medicaid but making less than 133% of the poverty level. The Supreme Court, while it upheld the Affordable Care Act, struck down that part of the Medicaid expansion that effectively made it mandatory for states to adopt. Instead, Medicaid expansion is up to the states to decide. The federal government will foot the entire cost of the expansion for the first few years and the lion’s share of the expansion (80% – 90%, I think) after that. Of course, Congress, like any governing body, can change its mind in the future.

There are about 400,000 Hoosiers in this ACA/Medicaid doughnut hole. Governor Pence, of course, has political and policy objections to health care reform. Instead of going with the federally funded Medicaid expansion for 400,000 Hoosiers, he wants to stick with the “Healthy Indiana” plan that covers more like 36,000 Hoosiers. According to the Carden article, the Pence administration is not working on a Medicaid expansion alternative in case the federal government says, “no.”

As for the 400,000 Hoosiers set to be blocked from enrolling in traditional Medicaid and seemingly unlikely to have an Indiana alternative, Minott said they still have plenty of options to obtain health care.

“We will be making sure they are aware of the community health centers in their communities, free clinics that are available in multiple places around the state and other safety net-type resources,” Minott said.

Anyone with passing familiarity with our medical system might be skeptical as to how “plentiful” these “safety net-type” resources really are.

Brian Zimmerman, writing for the Palladium-Item has an article entitled Pence: Tax cut, spend is possible. Gov. Pence made a speech at my old stomping grounds – Forest Hills Country Club.

Seriously, I spent a ton of time there. My folks were avid golfers, so when I was too young to golf, I was at the pool with my sisters. One of my best friends’ dad’s was the golf pro there before my uncle became the pro. My two brothers and I worked in the pro-shop at various times. (I worked there for 5 years – washing the clubs of, among others, the father of a current state Supreme Court justice and the father of a PGA pro.) For many years, most summer days seemed to consist of golfing there, working there, or hanging out with other kids who golfed and worked there.

But, I digress. Gov. Pence gave a speech there. In that speech, he apparently told the crowd that we can have our cake and eat it too. He characterizes Indiana as having “the largest surplus” in the state’s history. No doubt you have to squint and tilt your head just right to see it; selectively ignoring inconveniently large obligations of the state – unemployment insurance fund bail out money from the feds we have to pay back and underfunded state pensions come immediately to mind. Anyway, the surplus is so large, he says, that we can afford his promised 10% tax cut and, at the same time, spend more on roads and education and address Indiana’s 8.7% unemployment and 22% of Hoosier children living in poverty.

It’s a fine line to walk, trying to simultaneously brag about the fruits of sound fiscal policy for the last 8 years while also saying we don’t have enough money for the stuff you don’t happen to like; e.g., we have enough money for tax cuts, but not enough for Medicaid expansion (unless we use Indiana’s more expensive, less effective health care model).

So, what I’m really trying to say is that this winter is dragging on too long, and I’d really rather stop reading about politicians and go golfing. Also, you can see why my natural political inclinations are, pretty literally, those of a country club Republican.

John Krull has a column in the Louisville Courier Journal on the new governor entitled Gov. Mike Pence’s ‘Roadmap’ for Indiana still wandering.

Gov. Pence’s legislative history never suggested a love for policy details. He’s more of an “idea man,” particularly, I think, where those ideas are abstracted from the facts on the ground. Facts are messy things and don’t lend themselves well to the sort of uncompromising ideology that has been a hallmark of the governor’s career so far. (I think an effective legislator has to approach his or her ideology in much the same way Capt. Barbossa approached the Pirate Code (“the code is more what you’d call ‘guidelines’ than actual rules.”)

In any case, whether this is the problem or not, Krull discusses some restlessness in the General Assembly about Gov. Pence’s tepid policy leadership so far. The campaign was vague, the inauguration was vague, the State of the State was vague, and 1/4 of the way through the long session, the governor’s office has not apparently been very active on specific policy initiatives.

Krull concludes, “. . . at some point, Mike Pence will have to stop waving his roadmap around, get behind the wheel and drive the state somewhere. The question that remains is where he wants to go.”