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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. These liberals are out of control. They want to drive our economy into the ground and double and triple our electric bills. Sierra Club, stay out of Indy!

  2. These activist liberal judges have gotten out of control. Thankfully we have a sensible supreme court that overturns their absurd rulings!

  3. Maybe they shouldn't be throwing money at the IRL or whatever they call it now. Probably should save that money for actual operations.

  4. For you central Indiana folks that don't know what a good pizza is, Aurelio's will take care of that. There are some good pizza places in central Indiana but nothing like this!!!

  5. I am troubled with this whole string of comments as I am not sure anyone pointed out that many of the "high paying" positions have been eliminated identified by asterisks as of fiscal year 2012. That indicates to me that the hospitals are making responsible yet difficult decisions and eliminating heavy paying positions. To make this more problematic, we have created a society of "entitlement" where individuals believe they should receive free services at no cost to them. I have yet to get a house repair done at no cost nor have I taken my car that is out of warranty for repair for free repair expecting the government to pay for it even though it is the second largest investment one makes in their life besides purchasing a home. Yet, we continue to hear verbal and aggressive abuse from the consumer who expects free services and have to reward them as a result of HCAHPS surveys which we have no influence over as it is 3rd party required by CMS. Peel the onion and get to the root of the problem...you will find that society has created the problem and our current political landscape and not the people who were fortunate to lead healthcare in the right direction before becoming distorted. As a side note, I had a friend sit in an ED in Canada for nearly two days prior to being evaluated and then finally...3 months later got a CT of the head. You pay for what you get...

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