Tuesday, November 13, 2012

Pence and the Indiana Healthcare Exchange

[Secretary Sibelius has now pushed exchange deadline back to December 14.]

Does the date Nov. 16 ring any bells? That's the day that Gov. Daniels has to tell the federal government, based presumably on the advice of Governor-elect Pence, how Indiana will proceed on a healthcare exchange. The choices are to create a state-run exchange, to place Hoosiers in a federally run exchange, or create a hybrid system. You may recall that John Gregg thought the hybrid system would give Hoosiers the most flexibility--he's a pragmatist, after all. Back in August Pence wrote to Gov. Daniels that he was opposed to a state-based or hybrid exchange because of political, regulatory, and legal uncertainty. In the meantime, Democrats derailed any political threat to the plan by holding the Presidency and the Senate, and legal questions were resolved by the Supreme Court upholding its constitutionality.

Pence also argues that the exchange would cost Indiana $50 million a year, completely rejecting the notion that Hoosiers will save anything on insurance costs, despite the fact that such group purchase plans save people money in any number of settings. So it would appear that what remains is ideology, of which we will see a lot in the next four years.

Ironically, Pence's position will force Hoosiers onto the tender mercies of the despised federal government for their health care insurance. Presumably, Gov.-elect Pence is apparently prepared to put ideological purity above what he would consider best interests of his constituents.