Medicaid & Obamacare: Mind the Gap

Eric Bradner, writing for the Evansville Courier Press has an article entitled BRADNER: Pence, some lawmakers at odds on Medicaid expansion. Rep. Clere’s HB 1581 is the vehicle for Indiana’s Medicaid expansion. Gov. Pence doesn’t like it.

The back story, for those who haven’t been following, is that Obamacare was designed in two major pieces – one as an expansion of Medicaid for those between the current threshold up to 133% of the poverty line. Those above the 133% line have to buy insurance; with subsidies being supplied to poorer people who are required to buy that insurance. The Supreme Court decision threw a monkey wrench into the process by saying that the legislation had to allow the States to decide for themselves whether to implement Medicaid expansion. This leaves the people between the current Medicaid threshold and 133% of the poverty line in a bad way when it comes to paying for healthcare.

And, as we have recently learned from Steven Brill’s long piece in Time Magazine (and a recent Indiana Supreme Court case), these people in the gap are the most at mercy of the bloated prices of the hospital chargemasters. (Nobody else actually pays these prices except for the uninsured.)

Other very conservative governors have agreed to sign on to the Medicaid expansion — paid for almost entirely by the federal government. So, Pence has political cover if he wants to do what’s good for Hoosiers and their health. That’s what a number of Republican and Democratic members of the General Assembly would like to do. It remains to be seen if Gov. Pence wants to continue battling a fight against Obamacare that’s already been lost.


    • Carlito Brigante says

      I would think that even Med pay would cap payments at “reasonable and customary.”

      But Dog is right, the payments are often small amounts.


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