Negotiation and compromise — all but absent in Washington, D.C., these days — appear to be occurring between the administrations of Indiana Gov. Mike Pence and President Obama. The well-being of hundreds of thousands of Hoosiers could benefit from this encouraging turn of events.
Pence met Monday with Sylvia Burwell, the president’s secretary of Health of Human Services. His mission was to work out a long-awaited agreement with the federal agency on Pence’s alternative to expanding Medicaid coverage under Obama’s Affordable Care Act to more than 350,000 uninsured Indiana residents. The governor wants to use the Healthy Indiana Plan — which involves the consumers paying into a health savings account to inspire wiser health-care decisions — instead of expanding Medicaid as prescribed under the ACA. All of the neighbor states — Kentucky, Ohio, Michigan and Illinois — have already made that standard expansion.
Those expansions allow coverage to folks earning 138 percent of the U.S. poverty level. Pence has refused to expand Medicaid in the same manner as those border states and opposes it in principle. He’s labeled it as a broken program, which involves state and federal management. Pence sees his option to the ACA-style expansion, called Healthy Indiana Plan (or HIP) 2.0 and based on a small pilot project under former Gov. Mitch Daniels, as a “better and more effective alternative.”
His idea has drawn criticism from both ends of the political spectrum. That is a good sign, and it actually puts Pence in the company of the president he so adamantly opposes. Supporters of the ACA insist Pence’s demands for pay-in by poor and low-income consumers creates hardships. Arch rivals of “Obamacare” consider “Pencecare” a political betrayal by the governor for making any effort to work with President Obama to deliver even a state-customized version of the Medicaid expansion.
Is the governor walking this tightrope to soften his image, as an unbending conservative, in advance of a run for president in 2016? Maybe. Still, the end result of his approach to this situation shows some creativity, guts and willingness for give-and-take. That spirit of compromise needs to continue, not only by the governor’s team but also the president’s staff. Indiana hospitals “eagerly await” an agreement, according to a statement issued Monday by Doug Leonard, president of the Indiana Hospital Association. Those Hoosier facilities have seen their Medicare reimbursements slashed under the ACA, without receiving expanded Medicaid revenues in return.
After Monday’s meeting with the HHS secretary, Pence said, “We had a substantive discussion, but we are not there yet. Our administration will continue in good faith regarding our proposal to cover more low-income Hoosiers the Indiana way.”
Approval of HIP 2.0, in time for 2015 enrollment, would benefit thousands of Hoosiers, the state’s economy and its health-care system. We applaud the governor’s ingenuity and urge him and federal officials to continue negotiating until a solution is reached. The sooner the better.