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Can Indiana Afford the Affordable Care Act

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.

 

  • cynical sam

    Gee……..so you are saying that elections have consequences. Who woulda thunk.

    Actually tho, to paraphrase uncle Joe Stalin,

    “It is not important how many vote, it is important who counts the votes.”

    Keep believing in that whole Republic thingy and keep your eyes on the healthcare sector of the stock market for answers.

  • Doug

    First of all, “the patient” is the population of Indiana; so your analysis is incomplete without taking a look at whether this would result in an overall improvement in citizen health and health care delivery. 

    Second, we need some solid numbers – to the extent possible. A couple of days ago, I think you were saying $2 billion per year. Now you’re saying $2.5 – $3.1 billion over 6 years. Gov. Daniels is saying $2 billion over 10 years. Another report said that the overall cost to all the states of the expansion was $2 billion per year with Missouri’s (being the example) share being $150 million per year. 

  • Paul Wheeler

    “the discussions have now moved to how the plan would be implemented”.  Jumping the gun?  I would submit that we’re not there yet, since the Court recognized the soverignty of States not to comply at all.  That where the real discussion comes. 

  • cynical sam

    To your second point, since the recission/suspension of FASB and GAAP there is no such animal as “solid numbers”.  There is also the whole inflation/defaltion argument where any numbers are what the FED directs the value of the FRN is at that particular point in time.  Of course, since the US threw down the “SWIFT” gaunlet that was to take affect on 07/01/12 against Iran and anyone trading with Iran, the sole response had been laughter. Bye-bye US dollar reserve currency Bretton Woods BS. 

  • Dave

    This new “tax” is more like the Deplorable Destruction Act.  

    The lovie big govie utopian paradox is one of arrogant assumption.  The sovereign are adjudged to be “patients;” their lives a disease wherein impulses are celebrated as “natural” yet pregnancies are an affliction of inconvenience.

    Translation:  The “sovereign” are no more than misguided flunkies, in need of oversight & lifestyle management, from a ruling political caste.

    While “contemporary” or “progressive” in its cynicism, Roberts’ opinion is one of failed scholarship; that which is peddled by government (merchants of misery) as “education.”  Roberts’ missteps combined with Sotamayor’s failure to recuse herself for obvious reasons of conflict, are political punctuation on the hacktivist nature of the court.  

    If we removed her blindfold & she studied facial expressions, lady justice wouldn’t need further interpretation, of the five justice, single finger salute.    

            

  • M Theory

    This “patient” in Indiana wants nothing to do with government health care.  I’ll take my chances on my own, thank you.   Nor do I desire to pay for the health care of other people who do not contribute to society.

    Once you give people a freebee they take advantage.  Just ask the ambulance drivers how many times they are called out because someone (who doesn’t contribute to society) wants an aspirin.  It’s alarming, actually.

  • Ramon

    First of all,  this patient is fully 100% in support of ACA.  We are already paying for much of that care through increases costs of drugs, office visits and hospital treatments.  When they treat an uninsured people,  the cost has to come from someone.  Secondly,  if uninsured people have coverage where they get get PSAs,  pap smears,  colonoscopies and other preventive or diagnostic care,  the cost will go down due to early detection of medical conditions.  I think it is a win-win for everyone including the insurance companies who will have more policy holders and service providers who have to write less off.

  • cynical sam

    What color are the unicorns on your planet?

  • Dave

    This crap is heavy on reality suspension & role play; so as to be morbidly proportioned.

    Welcome to Planet Utopia, where politicians are “care givers” & everyone else is a “patient.”
    Panel… er nurse, please fit our friend Ramon with a gown…

  • Pascal

    http://blog.heritage.org/2012/07/05/morning-bell-governor-walker-breaks-new-ground-in-higher-ed/?roi=echo3-12479641793-9064558-4531c084dc9297e586900700ca283be5&utm_source=Newsletter&utm_medium=Email&utm_campaign=Morning%2BBell    So you raise costs in one area and greatly reduce them in another.  Walker’s Plan looks a lot like Indiana’s newest University.  Guessing that Purdue will soon be a world leader.