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Pence won't implement Obamacare health exchange
Republican gubernatorial candidate Mike Pence has opted not to seek to implement the Obamacare health exchange. (HPI Photo)
8/21/2012 1:41:00 PM
By BRIAN A. HOWEY
NASHVILLE, Ind. - Republican gubernatorial candidate Mike Pence has notified Gov. Mitch Daniels that he will not support the implementation of the Obamacare state health exchange in Indiana.
On July 30, Daniels had sought input on the Affordable Care Act from Pence and the two other gubernatorial candidates, Democrat John Gregg and Libertarian Rupert Boneham. Pence met with Daniels at the governor's Statehouse office last week.
In a letter to Daniels released Tuesday, Pence said that he "carefully considered this option" but said there was "too much uncertainty surrounding the Affordable Care Act to make it prudent for Indiana to even consider moving forward in implementing our own exchange."
Pence made four points:
"First, the national debate over the Affordable Care Act is far from over," said Pence, a vociferous opponent of Obamacare, voting against it in March 2010 and on 33 other House votes to repeal. "While the Obama Administration, its allies in Congress and the Supreme Court have had their say on this health care law, the American people will have their say in November. With such political uncertainty surrounding the Affordable Care Act, it would not be prudent for the state to require Hoosiers to spend their time and hard-earned money on the implementation of a federal health care law that may be overturned in the next Congress."
Second, Pence said, "There is too much regulatory uncertainty surrounding the operation of exchanges. The federal government is still delinquent on complete guidance for exchanges and there are many unanswered questions. Just last week, it was revealed that the federal government still refuses to answer whether the Healthy Indiana Plan can serve as the coverage vehicle for the Medicaid expansion under the Affordable Care Act. Furthermore, a state operated exchange will still be subject to federal oversight, regulation and delay in the future. Operating our own exchange might seem like a way around the health care law’s onerous regulations right now, but the way the regulations are written, the federal government will be hyper-regulating state-based exchanges. This would reduce the State of Indiana to a branch office of the Department of Health and Human Services, and leave Indiana lawmakers to blame for the price increases that will occur and for market related decisions that are largely outside their control. All told, this is entirely too much regulatory uncertainty to justify moving forward at this time."
Third, Pence explained, "There is fiscal uncertainty. The cost to Hoosier taxpayers for setting up our own exchange could be at least $50 million per year and perhaps higher. There is no evidence that this investment will improve the lives of Hoosiers, or will lower the cost of health insurance. This is money that would be better invested in helping our kids achieve educational results, providing tax relief for all Hoosiers, or addressing the cost drivers of health care and improving quality and health outcomes."
Finally, the Columbus Republican said, "There is legal uncertainty surrounding state-operated exchanges. Some experts argue that the Affordable Care Act’s mandate on employers, which would raise taxes on Hoosier businesses by imposing a tax penalty if those employers fail to provide federally-approved health coverage policies for their employees, can only be triggered by the granting of premium subsidies to finance purchasing individual policies on a state-based exchange. The Internal Revenue Service recently issued an interpretive rule attempting to clarify that subsidies which clearly apply to purchases made on state-based exchanges also apply to purchases made on federal exchanges, which makes it all the more likely that the issue will be litigated at some point in the future."
Pence concluded, "With our unemployment rate at 8.2 percent and too many Hoosiers out of work, I will not support the implementation of an Indiana exchange when there is a chance that doing so would lead to a tax increase on Hoosier employers."
Pence noted that in 2007, the Indiana General Assembly crafted a "bipartisan, innovative solution on both cost and access." Called the Healthy Indiana Plan, more than 40,000 Hoosiers have access to health care through HIP, along with a POWER account that gives them a financial incentive to find the most affordable health care services and to improve their health.
Pence noted that according to a recent survey, 94 percent of participants were satisfied with the program and 99 percent indicated that they would re-enroll. "The Healthy Indiana Plan therefore empowers Hoosiers in a way that will increase access to health care and drive down the cost, and I believe it is the model that should serve as the starting point for all future discussions of health care reform in Indiana," Pence explained. "Unfortunately, the Obama Administration and its allies in Congress charted a far different course in 2010."
Democrat John Gregg has not met with Gov. Daniels and has been noncommittal on the issue. His campaign has told the Evansville Courier & Press that Gregg will meet with the governor in the next couple of weeks.
Pence, Gregg and Boneham meet at 7 p.m. tonight at IUPUI as part of "Policy Choices for Indiana's Future Forum" hosted by former Chief Justice Randall T. Shepard.
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