Jim Shella is reporting on political opposition to Gov. Pence’s view that Indiana should not take part in the Medicaid expansion part of the federal health care reform legislation. The Supreme Court held that states should have the ability to opt out.
Sen. Lanane says that if Indiana does opt out, it will be known as an “island of the uninsured.” On the map, if memory serves, the Island of the Uninsured is roughly southwest of the Island of the Misfit Toys across the Sea of Bad Ideas.
I think we’re going to pay the federal taxes anyway. The main question is whether they’ll come back to Indiana in the form of Medicaid dollars that will support 400,000 Hoosiers. The law provides for 100% federal funding through the first few years and 90% thereafter. There is a long term concern for those who don’t much like Medicaid in the first place; and I think Gov. Pence is one of those. The concern is that, sure, the federal government is funding the program now and promises to fund the lion’s share in the future; but what’s to say it won’t renege on that promise?
From that perspective, I think you have to figure out the lesser of evils. On the one hand, a potential financial burden for the state in the future that the state can opt out of if it’s bad enough; on the other hand hundreds of thousands of Hoosiers not getting health care coverage, leading to more sick and dead citizens, despite millions of Hoosiers paying federal taxes that could be available to fund that coverage locally instead of in other states. Seems like a no brainer to me, but then I don’t have political purity to worry about. By contrast, Gov. Pence doesn’t want to end up like Sen. Lugar.