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Debate erupts on Indiana's incomplete Medicaid waiver

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Indiana Gov. Mike Pence defended his administration Thursday over criticism from Democratic lawmakers that they have imperiled Hoosiers' health care by failing to follow proper procedures on Medicaid.

In a letter to state Democratic leaders, Pence insisted his administration did not err by filing an incomplete Medicaid waiver with the Centers for Medicare and Medicaid Services and called the federal approval process "flawed."

Pence asked CMS' approval to complete the federal Medicaid expansion for residents earning up to 138 percent of the federal poverty level using the Healthy Indiana Plan, a hybrid health savings account plan that he argues would give the state more control.

However, Diane Gerrits, CMS' director of state demonstrations and waivers, wrote in a Feb. 25 letter that the state will have to resubmit its application because it had not yet held two public hearings required by law.

House Minority Leader Scott Pelath, D-Michigan City, and Senate Minority Leader Tim Lanane, D-Anderson, wrote to Pence on Thursday saying his move put the state in danger of losing the program and could also freeze lawmakers out of the decision.

"As a result of the failure to comply with the transparency portion of the proposal, it now appears that we must begin a 30-day state public comment and notice period, followed by an additional 30-day federal public comment and notice process, later than expected," the pair wrote.

Pence contends, however, the state faces no delay.

"The Feb. 25, 2013, letter from HHS does not indicate in any way that the waiver application process has been jeopardized," he wrote Thursday. "It does, however, speak to the flawed bureaucratic process that has impeded progress on our successful Healthy Indiana Plan."

Pence spokeswoman Christy Denault said state officials have been talking regularly with CMS officials, and said giving CMS the incomplete application allowed them to begin vetting the application. CMS officials did not respond to questions Thursday afternoon.

If Pence's plan is approved, it could provide coverage for an additional 400,000 low-income residents. If it is rejected, it could end coverage for the roughly 40,000 residents already enrolled in HIP. And a decision has to be made by June, six months before the state's current waiver expires. Additionally, Pence has said he might not sign off on the expansion using HIP even if he wins federal approval.

A pair of public hearings have been scheduled in Indianapolis next week. Denault said the final, completed waiver, should be submitted by April 11.

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  1. Aaron is my fav!

  2. Let's see... $25M construction cost, they get $7.5M back from federal taxpayers, they're exempt from business property tax and use tax so that's about $2.5M PER YEAR they don't have to pay, permitting fees are cut in half for such projects, IPL will give them $4K under an incentive program, and under IPL's VFIT they'll be selling the power to IPL at 20 cents / kwh, nearly triple what a gas plant gets, about $6M / year for the 150-acre combined farms, and all of which is passed on to IPL customers. No jobs will be created either other than an handful of installers for a few weeks. Now here's the fun part...the panels (from CHINA) only cost about $5M on Alibaba, so where's the rest of the $25M going? Are they marking up the price to drive up the federal rebate? Indy Airport Solar Partners II LLC is owned by local firms Johnson-Melloh Solutions and Telemon Corp. They'll gross $6M / year in triple-rate power revenue, get another $12M next year from taxpayers for this new farm, on top of the $12M they got from taxpayers this year for the first farm, and have only laid out about $10-12M in materials plus installation labor for both farms combined, and $500K / year in annual land lease for both farms (est.). Over 15 years, that's over $70M net profit on a $12M investment, all from our wallets. What a boondoggle. It's time to wise up and give Thorium Energy your serious consideration. See http://energyfromthorium.com to learn more.

  3. Markus, I don't think a $2 Billion dollar surplus qualifies as saying we are out of money. Privatization does work. The government should only do what private industry can't or won't. What is proven is that any time the government tries to do something it costs more, comes in late and usually is lower quality.

  4. Some of the licenses that were added during Daniels' administration, such as requiring waiter/waitresses to be licensed to serve alcohol, are simply a way to generate revenue. At $35/server every 3 years, the state is generating millions of dollars on the backs of people who really need/want to work.

  5. I always giggle when I read comments from people complaining that a market is "too saturated" with one thing or another. What does that even mean? If someone is able to open and sustain a new business, whether you think there is room enough for them or not, more power to them. Personally, I love visiting as many of the new local breweries as possible. You do realize that most of these establishments include a dining component and therefore are pretty similar to restaurants, right? When was the last time I heard someone say "You know, I think we have too many locally owned restaurants"? Um, never...

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