---- — On Aug. 24, 2001, a French stuntman named Thierry Devaux tried to bungee jump off of Lady Liberty’s torch in the New York harbor, and ended up dangling on his parasail from her wrist.
It was a whimsical moment that delighted tourists, cable news producers and viewers across the globe. New York Mayor Rudy Giuliani would call the thrill-seeking “Terry Do” an “idiot” as the moment disappeared into the late summer haze and, a few weeks later, a maelstrom.
That, of course, would be the Sept. 11 terror attacks just across the harbor. “Terry Do” became terror pilots, the World Trade Center towers fell, and everything changed.
Indiana’s political and policy establishment has been riveted by a series of emails from former Gov. Mitch Daniels and former Supt. Tony Bennett that has now led to an investigation in the A to F school grading program. Earlier this year, everyone was obsessed with Gov. Mike Pence’s income tax cut.
The real billion dollar story — the maelstrom on the brink — is Obamacare and the impact it is going to have on hundreds of thousands of poorer Hoosiers, tens of thousands of families, the state’s community hospital systems, local safety net organizations, the more than $10 billion Indiana lawmakers may leave on the table, and the next generation of state and local budgets.
There are so many facets of this story that we don’t know about, that this is essentially a call to action for the various news organizations, reporters and opinion shapers to go out into their communities - and into the Indiana Statehouse and agencies and begin to ask the hard, penetrating questions.
Right now, we have about a thimble full of relevant information on this topic and there is an ocean of data to process.
So much of the debate over Obamacare has taken on sharp, partisan and ideological trimmings. But the fact is, it’s the law of the land and it is going to require pragmatism to deal with the myriad of impacts.
Right now, Indiana’s leaders are preoccupied with mostly denouncing Obamacare and calling for a repeal. U.S. Rep. Marlin Stutzman has talked about it in the context of a potential government shutdown rather than fund Obamcare, though he says there is plenty of time to negotiate.
And in Galesburg, Ill., on July 24, President Obama reiterated his stance that the reform would move forward. There was an election about nine months ago, and American voters reelected Obama and a Democratic Senate, while Hoosiers sent Democrat Joe Donnelly to the upper chamber.
Gov. Pence and those who loathe Obamacare can wish and wish and wish it to go away. But Republican U.S. Sen. Dan Coats has told me that a repeal is unlikely. Others talk about repeal after Obama leaves office, but the entire medical and insurance industry will be settled into the new law and there’s no guarantee the next president will be a Republican.
Gov. Pence is seeking a waiver from U.S. Health and Human Services to extend the Healthy Indiana Plan for the 37,000 now enrolled. He wants to use it as an expansion.
It appears as if Indiana’s leaders are putting all the eggs into repeal or the HIP expansion. But multiple sources who have worked on health issues in Indiana tell me it is unlikely the federal government will accept HIP as an expansion vehicle and even if they do, it will be dramatically changed. It would have to in order to absorb up to 400,000 more enrollees.
Several sources have characterized the dynamic between Gov. Pence and the Obama administration as a historic “game of chicken.”
Gov. Pence has vowed never to expand traditional Medicaid. The option in that scenario, is that Indiana then leaves about $10 billion in federal funding (which Hoosier taxpayers contribute) on the table.
Question for local reporters and editors? What happens to your local hospitals should this occur?
My sources say that local medical community leaders are walking a tight rope. Many are conservatives skeptical of Obamacare. But the loss of Medicaid funding poses a huge dilemma. They are reluctant to alienate Gov. Pence at this point.
What happens to the urban medical centers which get the “disproportionate share hospital” (DSH) payments for serving large indigent populations? This would include Wishard in Indianapolis, Parkview in Fort Wayne and Methodist in northern Lake County.
I have Republican sources in the medical community and at the Statehouse who acknowledge, “That’s a valid concern.” Some believe it will lead to a crisis and cost taxpayers more in the long run.
Family and Social Services Administration Commissioner Debra Minott suggested in June that without a Medicaid expansion, “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.”
Local reporters should be asking their community safety net organizations about their current needs and ability to expand services.
There is so much work to do, so many questions to ask, and our leaders need to have a candid, pragmatic discussion with citizens. Virtually none of this is happening now.
Brian Howey, a Peru native, is the publisher of The Howey Political Report. He can be reached at www.howeypolitics.com. Find him on Twitter @hwypol.