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Indiana legislative leaders ponder health costs

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Indiana's top lawmakers said Monday they're not sure what to expect from the federal health care law other than greater costs at a time the state's budget is already stretched thin.

Republican Senate President Pro Tem David Long said the state no doubt would have to absorb some hidden expenses, even if the federal government sets up Indiana's online exchange allowing consumers and businesses to shop for insurance. That coupled with a potential Medicaid expansion could make the law a long-term burden on Indiana taxpayers, he said.

"It's absolutely a freight train coming down the tracks that's going to be shoved off on the states. And a lot of the cost has to do with the situation in Washington," he said, adding that Washington's budget woes make it more likely states will bear the burden of the sweeping law.

The Republican and Democratic leaders of the General Assembly spoke Monday at a forum hosted by the Indiana Chamber of Commerce.

Gov.-elect Mike Pence opposes the state running its own insurance exchange. The federal government would build one for the state if he declines a partnership with the federal government by February.

But even though his rhetoric against President Barack Obama's signature legislation remains sharp, Pence may not be ruling out a state-run exchange long-term. Republican House Speaker Brian Bosma says Pence has told him the state could retake control of the exchange after a year if it works well.

The Legislature will have a full plate when it begins work in earnest starting January. Besides questions about health care, lawmakers must craft the next biennial budget, address educations and jobs proposals and consider whether to write Indiana's gay marriage ban into the state constitution.

Lawmakers enter the 2013 session with roughly $2 billion in cash reserves and a proposal from Pence to use at least part of that money to cut the personal income tax by 10 percent. But Long cautioned that gambling income from the state's riverboat casinos and slots operations has been declining, and Bosma said it would be hard to commit to very much new spending or tax cuts because "the fiscal fog is thick."

The actuary hired by the state, Milliman, estimated in September that even if the state decided not to expand Medicaid coverage, the health care law could cause poor residents not already covered by Medicaid to be forced out of the "woodwork" by the requirement that they be insured. That alone would cost roughly $612 million over seven years.

"I think there has been some discussion about whether those figures are completely accurate, whether they take into account some of the savings that also might be reaped from the implementation," said Democratic Senate Minority Leader Tim Lanane. "There is controversy as to exactly how reliable those figures are."

Republicans in control of the Senate and House also will have to deal with a new school superintendent who campaigned against many of the education changes approved the last few years. Democrat Glenda Ritz is replacing Republican Tony Bennett, a staunch advocate of the GOP's education overhaul.

Bosma pointed out that many of those new changes, including a sweeping school voucher system and merit pay for teachers, are already in the books. But she could have sway over how those laws are placed into practice, he said.

"The reforms will not be rolled back," he said. "That doesn't mean we can't have a conversation about how they will be implemented. I think we've all had some reservation about them."

One proposal being considered by lawmakers would make the state school superintendent a position appointed by the governor, but Bosma cautioned the day after the election that he would like to talk to Ritz first before making any changes.

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  • health care law
    Why is there never any mention of how the health care law is going to HELP the residents of Indiana? People who are uninsured will now have access to insurance. This is a good thing. Pence never once mentions the upside to this law. He is only against it because it was put in place by a democratic president.

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  1. John, unfortunately CTRWD wants to put the tank(s) right next to a nature preserve and at the southern entrance to Carmel off of Keystone. Not exactly the kind of message you want to send to residents and visitors (come see our tanks as you enter our city and we build stuff in nature preserves...

  2. 85 feet for an ambitious project? I could shoot ej*culate farther than that.

  3. I tried, can't take it anymore. Untill Katz is replaced I can't listen anymore.

  4. Perhaps, but they've had a very active program to reduce rainwater/sump pump inflows for a number of years. But you are correct that controlling these peak flows will require spending more money - surge tanks, lines or removing storm water inflow at the source.

  5. All sewage goes to the Carmel treatment plant on the White River at 96th St. Rainfall should not affect sewage flows, but somehow it does - and the increased rate is more than the plant can handle a few times each year. One big source is typically homeowners who have their sump pumps connect into the sanitary sewer line rather than to the storm sewer line or yard. So we (Carmel and Clay Twp) need someway to hold the excess flow for a few days until the plant can process this material. Carmel wants the surge tank located at the treatment plant but than means an expensive underground line has to be installed through residential areas while CTRWD wants the surge tank located further 'upstream' from the treatment plant which costs less. Either solution works from an environmental control perspective. The less expensive solution means some people would likely have an unsightly tank near them. Carmel wants the more expensive solution - surprise!

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