Lowering health care costs, improving childcare access, attracting and retaining talented employees and creating a state energy plan are among the top priorities of business leaders as Indiana lawmakers prepare to return to the Statehouse next year to pass a two-year budget.
Members of the Indiana Chamber of Commerce laid out their agenda during the chamber’s annual legislative preview luncheon on Monday, less than six weeks before lawmakers consider dipping into the state’s $6.1 billion surplus to address key issues, including health care, education, energy and workforce development during the 2023 session.
Lawmakers will meet Tuesday for their annual organization day in advance of the 2023 session.
Indiana ranks seventh highest in the nation for hospital costs, according to a study from the RAND Corporation, and 18th in health care costs, according to the Kaiser Family Foundation. Earlier this year, lawmakers asked health care providers, pharmaceutical companies and insurers to come up with ideas for how to reduce health care and hospital costs.
To address the shortage of primary care physicians and nurses in the state, the chamber is pushing for the legislature to look at state laws and regulations, commonly called scope of practice, that define what services other health care professionals can provide.
“In some cases, the current scope of practice laws may restrict access to care by contributing to shortages of clinicians, which in turn may exacerbate market conditions and ultimately contribute to higher health care costs,” said Mike Ripley, Indiana Chamber vice president of health care policy and employment law.
The panel also discussed the need for more robust public health spending. In August, the Governor’s Public Health Commission released a report recommending an additional $240 million in annual public health spending to bring Indiana in line with the national average for spending per capita. When compared to other states, Indiana has higher than average rates of smoking, obesity, infant mortality and maternal mortality.
Senate President Rod Bray, R-Martinsville, said he couldn’t see the Senate allocating the full amount recommended by the commission, though he agreed more funding was needed to improve the state’s public health outcomes.
“I don’t see us spending $480 million on public health,” Bray said. “I’m not even sure if we sent that kind of money to local health departments that they would be able to handle it well,” Bray said.
House Speaker Todd Huston, R-Fishers, said Hoosiers need to take some personal responsibility for their own health instead of relying on government solutions.
“It’s no great shock that how you eat matters and exercising matters,” Huston said. “How do you improve health care outcomes? First and foremost, it’s personal responsibility. And I think that sometimes gets lost in these discussions, and it becomes about what government is going to do.”
Senate Minority Leader Greg Taylor, D-Indianapolis, said the state needs to play a larger role in reducing health care costs.
“Access to health care is the first step,” Taylor said. “You can do everything you want from taking care of yourself to eating right, but your body is eventually going to break down…We can’t have the government approving medications and taking no responsibility for the cost of it.”
The chamber also supports doubling the state tax on cigarettes to $2. Bray said it’s “highly unlikely” that will happen. Indiana currently imposes a $1 tax on a pack of cigarettes.
Education and workforce development
The chamber is asking lawmakers to strengthen college and career readiness expectations and opportunities for students by automatically enrolling eligible students in the state’s 21st Century Scholar Program and creating “diploma plus” funding incentives for high school graduates to earn a postsecondary credential concurrently with a diploma.
Huston said the state’s higher education institutions also need to reconfigure their offerings as economic pressures force more Hoosier families to forgo postsecondary education.
“Higher education has lost their value proposition for all families, and that’s not just in Indiana but across the country,” Huston said. We created a high school [system] to feed higher ed.”
To attract and retain talent, House lawmakers have a plan to “reinvent high school” to provide more opportunities for work-based learning, Huston said. He also challenged employers to become more involved in the classroom setting.
The chamber also supports offering incentives to employers to enhance access to childcare programs, the creation of a state workforce retention/talent matching fund and targeted financial incentives that promote graduate retention and employer investment in work-based learning.
Energy and the environment
Indiana hasn’t passed a statewide energy plan since 2006, and the chamber believes it’s time for the state to develop a framework to transition from reliance on fossil fuels to a more diverse group of energy sources, including “clean coal,” natural gas, nuclear, renewables and other sources.
The chamber is pushing for changes that were recommended by the 21st Century Energy Policy Task Force, including more incentives for renewable energy.
Bray said moving too quickly toward renewables could hamstring the state’s energy grid.
“In the Midwest, when the wind isn’t blowing or the sun isn’t shining, we have to have that reliability,” he said.
House Minority Leader Phil GiaQuinta, D-Fort Wayne, said Indiana needs to make more aggressive moves toward renewables.
“The change is coming, and Indiana can be part of that change or not,” he said. “Frankly, it’s businesses around the state that are leading the effort on renewables.”