INDIANAPOLIS
(AP) — A study released Monday by the Indiana Hospital Association
estimates that expanding Medicaid would generate billions of dollars in
economic growth for the state, a stark contrast from the budget-busting
projections cited by former Gov. Mitch Daniels.
The hospital
association's study estimates that using the federal expansion to cover an
additional 406,000 residents would cost Indiana less than $500,000 but
pump several times that amount back into the economy over the next seven
years.
An actuary
hired by former Gov. Mitch Daniels' administration found the expansion
would cost a budget-busting $2.6 billion over the same time frame.
Using those
two vividly different analyses as markers, lawmakers in the Indiana House
and Senate were set to consider measures this week on how to implement the
federal health care law. Senate Health Chairwoman Pat Miller,
R-Indianapolis, will be pushing a proposal to expand Medicaid using the
state's health savings account programs, the Healthy Indiana Plan, while
Democrats will be pushing for the full expansion under the federal law.
Democrats and
supporters of an expansion, including the IHA, have argued the reports
Milliman Inc. issued for the state ignore major benefits from covering
more uninsured. The IHA study, conducted by researchers at the University
of Nebraska Medical Center, found that the could generate $108 million in
new tax collections as up to $3.4 billion is pumped into the economy each
year.
The goal of
the study is to give lawmakers a "positive" look at an expansion, said IHA
president Doug Leonard.
"I think the
state is taking a cautionary approach to it," Leonard said. "Medicaid has
long been a growing program for them. So they're just making sure they
aren't biting off something they will regret later. I think that's true of
a lot of states."
Milliman
determined that a "woodwork effect" — comprised largely of uninsured
children joining Medicaid rolls after seeking emergency room care — would
cost the state $612 million through 2020, without any expansion. Add in
coverage for residents earning up to 133 percent of the federal poverty
line, the full federal expansion, and Milliman puts the price at $2.6
billion.
The chasm
between the two studies can be explained by Milliman's charge, which is to
deliver a worst-case scenario, said David Roos, executive director of
Covering Kids and Families of Indiana. The IHA study was able to account
for the other side of the equation, he said, by assessing the benefits of
an expansion.
"They're not
caught in the conflict that Milliman is, it really does gets paid for
warning states what's the worst possible scenario," Roos said. "So they're
coming at it from two very different points of view."
New Gov. Mike
Pence budgeted for that "woodwork effect" but did not include any money in
the state's next two-year, $29 billion budget for an expansion. He has,
however, said he would sign off on an expansion via the Healthy Indiana
Plan, as Miller has proposed.
Senate
Appropriations Chairman Luke Kenley, R-Noblesville, said he is supporting
Miller's plan to expand HIP.
"One of the
big issues here is that no matter what you think the cost is, it's clear
there are going to be significantly more state dollars that's going to go
into this program," said Kenley, who will have to sign off on any type of
expansion for it to be successful. "And we would like to have some control
over the expenditure of our own state dollars to try to develop a good
medical plan that will get to the right people, and give them the right
services at the right cost."