Now that the U.S. Supreme Court has upheld the President’s health care plan, the Affordable Care Act (ACA), the discussions have now moved to how the plan will be implemented. I’m particularly interested in the expansion of Medicaid portion of the legislation. A lot of state lawmakers aren’t crazy about expanding the program, and they have good reason to think so.
Under the new rule, states will be given the option to expand Medicaid and the federal government will pick up the entire tab for the first few years and then 90% after 2020. That may sound like a good idea, but it isn’t really.
The problem with that 10% price tag is that it could end up taking a serious toll on the Indiana State Budget. An analysis of the ACA back in 2010 showed the program costing the state anywhere from $2.5 to $3.1 billion in over a six-year period starting in 2014. Up to a half million adults and children could be added to Indiana’s Medicaid rolls, bringing the entire state’s Medicaid population to 1.8 million by 2020. And successful programs like the Healthy Indiana Plan would be placed in limbo, or worse eliminated.
Where are the dollars going to come from to pick up the state’s portion of this Medicaid expansion? Will the money come from roads, education, prisons, and other state services? Critics of such an analysis say the true cost of the ACA to Indiana won’t be in the billions but closer to $540 million, at the same time, with a weak economy, where will the money come from to pay for this expansion.
And if that weren’t enough, what about the 2.3% tax on medical devices set to begin in 2013? This will have a major impact on Indiana as it is one of the leading states in the manufacturing of medical devices. Statewide, a study by the IU School of Business showed more than 18,000 jobs in Indiana could be impacted by the medical device tax. When has a tax on an industry ever resulted in more jobs and economic growth?
On balance, I can’t see how this is a good thing for Indiana? More people on government assistance, bigger burdens placed on states, higher taxes on a key industry? This can’t be a positive. Although I practice law and not medicine, I thought one of the key tenants of medicine was not to make the patient worse. At this rate, we may as well as call in Dr. Jack Kevorkian to come put Indiana out of its misery.