Since last summer’s U.S. Supreme Court’s ruling on the Affordable Care Act effectively gave states the option to expand Medicaid, policymakers across the country have debated if and how to extend health programs to millions of uninsured Americans.
If Indiana should decide to completely opt out, not only will our state’s hospitals face tremendous financial burdens, but hundreds of thousands of Hoosiers will remain without basic coverage. We support coverage because it is vital to hospitals’ collective mission of improving public health, as well as essential to ensuring the vitality of community hospitals in rural and urban areas.
Under the ACA, Indiana hospitals anticipated more than 400,000 Hoosiers would gain health coverage through a program like Medicaid or the Healthy Indiana Plan (HIP) to help offset $3.8 billion in cuts to hospitals over 10 years in Indiana alone. These cuts have already begun, and if not balanced with a significant increase in the number of insured patients, then rising levels of uncompensated care will threaten thousands of health care jobs and lead hospitals to reduce services or even close.
Approximately 860,000 people in Indiana are currently without any health insurance, and these patients often have no other avenue but the emergency room for basic care. Hospitals often treat complex, chronic conditions at great economic and social cost because, as research indicates, the uninsured delay what could have been inexpensive treatment.
Hospitals incur such losses as part of their service to the community, and as a result, are forced to reduce services and shift the burden to businesses and the privately insured. In 2011, Indiana hospitals provided nearly $3 billion in uncompensated care.
We ask policymakers to increase coverage because, after careful review, we feel a responsible and fiscally sound plan can be created. The Indiana General Assembly and Gov. Pence are seeking flexibility from the federal government to use HIP as a possible platform for covering more Hoosiers, and hospitals support these efforts. Since HIP was created in 2007, we have supported this successful program that has provided health care security to thousands who would otherwise have no option. Indiana will be well served if HIP is soon renewed and extended to even more of our state’s uninsured citizens.
We have an opportunity to improve public health and strengthen the future of the state’s hospitals, including those in Terre Haute and the Wabash Valley region. Hospitals are the engines of their local economies, employing more than 120,000 people, and without additional coverage for the uninsured — the economic impacts would be devastating.
The 400,000 individuals who could be covered by HIP are our neighbors, co-workers, employees and family members. As many as 35,000 of Indiana’s uninsured are veterans. The exact path we take as a state toward the goal of covering these citizens may be unclear, but the urgency is great.
We are hopeful that compromises will lead to the right plan for Indiana, and we pledge to work with stakeholders to craft a plan that is responsible for taxpayers while improving the lives of thousands.
Doug Leonard is president of the Indiana Hospital Association.