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September 9, 2013

HAYDEN: Health care safety net is tattered

In the war over the Affordable Care Act, Indiana Gov. Mike Pence won a policy victory when the Obama administration gave him a temporary pass to continue with the Healthy Indiana Plan, a high-deductible health insurance program that covers only 37,000 low-income Hoosiers.

The reprieve came on the condition that the state continues to consider its coverage options for another 300,000 uninsured Hoosiers – mostly the working poor — who’ve been left out in the cold by Pence’s decision not to expand traditional Medicaid coverage, as 25 other states have opted to do under the ACA.

During a press conference to announce the decision, Pence called it a “victory for Hoosiers” enrolled in the program (which has a waiting list of 55,000) as reporters questioned him about other Hoosiers without healthcare insurance.

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.”

Actually, according to the Indiana Hospital Association, about 2.7 million people walk (or otherwise transported) into emergency rooms in Indiana hospitals every year, many because they have no place else to go.

Pence’s call for hospitals to step up ignores the fact they’re already stepped up. According the Indiana Hospital Association, Indiana’s hospitals eat about $3 billion a year delivering uncompensated care to people who can’t pay their hospital bills. About $1.7 billion of that was the “charity care” that, by Indiana law, non-profit hospitals are required to deliver.

The hospitals don’t absorb all those lost dollars. Those of us with insurance do, said Linda White, president of Deaconess Health Systems in southwest Indiana, where one out of every four emergency room patients can’t afford to pay their medical bills. “Those costs are shifted to the people who can pay,” White said.

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