Saturday, October 25, 2014


Dr. Tim Brown, left, a Republican who represents House District 41 in the Indiana General Assembly, speaks with Tim Neese of Elkhart, a Republican who represented District 48, during the 2014 session. (Photo in.gov)
Indiana lawmakers Brown, Bucshon go into learning mode on the ACA

Posted on April 17, 2014 at 12:30 p.m.

INDIANAPOLIS — Seated across the table from me at Cafe Patachou were Drs. Tim Brown and Larry Bucshon.

Dr. Bucshon is a heart surgeon from Newburgh. Dr. Brown is an emergency room physician from Crawfordsville. What made this breakfast meeting extraordinary is that Brown is the powerful Republican chairman of the Indiana House Ways & Means Committee, which plays a huge role in developing $30 billion biennial budgets. Bucshon is the Republican congressman from Southwestern Indiana.

The two were embarking on a statewide “listening tour.” In more than three decades of covering Indiana politics, I cannot remember a legislator and member of Congress doing anything like this. And it couldn’t come at a better time.

The Affordable Care Act – or “Obamacare” – had just passed its first signup deadline. The Kaiser Family Foundation reported that 145,189 Hoosiers were eligible for coverage, 93,720 eligible for subsidies, 65,846 eligible for Medicaid, and 64,971 (through March 1) had selected a plan through the federal health exchange.

I had a personal bone to pick with these lawmakers. My 24-year-old son signed up for a plan that will cost him about $100 a month. Good for him. A middle-aged friend of mine qualified for a subsidy for his family of four and will be paying about $6 a month. That is not a typo: $6. Me? I’m a non-smoking 58-year-old self-employed single guy who has had a vasectomy. I earn too much for a subsidy. My previous plan cost me $350 a month. It went up to $444 last fall. And when the plan lapsed, I ended up on the federal Healthcare.gov website. An employee stayed on the phone with me as I went to the federal exchange (which worked flawlessly).

My total monthly cost: $718 a month.

I had shopped around prior and a broker from Mishawaka had warned me of “sticker shock.” Why, I asked, did the cost of my options go up so much? “Because you’re paying for maternity and pediatric benefits,” she told me.

When I told a Republican friend about my premium increase, he was exultant. “See! I told you so,” he responded.

The news for me is not entirely dismal. Having a pre-existing condition, I had been on the pre-Obamacare death spiral. As a self-employed individual, I had a terrible time finding insurance and when I did, it cost more than my final Obamacare total. The fact that I could go to a website and in 30 minutes find coverage was truly a breakthrough that Obamacare loathing Republicans should not discount.

As Obamacare passed in 2010 on a straight party line vote, we watched majority Democrats lard up the historic legislation with all sorts of things, like maternity/pediatric benefits for single older guys, and things like coverage and the 30-hour work week, which prompted a surge in layoffs. Democrat U.S. Rep. Joe Donnelly voted for the ACA and in doing so, said it would need to be tweaked. He later won a U.S. Senate seat in Indiana despite his vote. Former Democratic congressman Lee Hamilton correctly observed that this kind of social re-engineering without bipartisan support is deeply flawed.

In the intervening four years since the ACA passed, was there any tweaking?

No. House Republicans voted more than 40 times to repeal the law when the GOP didn’t control the Senate or the White House. Their office communication systems were not dedicated to public service, but anti-Obamacare propaganda.

I am personally paying for their politics when all I needed was access to good coverage at a decent price. And I am mad as hell about that.

So now we have these two powerful Republicans traversing Indiana. Both Brown and Bucshon ardently opposed the ACA, but both acknowledge it’s not going to be repealed.

They also agree that two huge elements are in play. First, 10,000 Baby Boomers are retiring every day and that is going to stress the system. It would have done so with the old one. Secondly, we are on the precipice of wonder drugs, where human genomes will allow individualized cancer treatments, for instance.

As Brown notes, not everyone is going to be able to afford such treatments. “I don’t think we as a society can say you can have whatever you want whenever you want it,” he said. “We can treat with this drug, or x-drug that is more expensive.”

And that will put you in bankruptcy, I said.

“And your family,” Brown responded.

Bucshon is a true free-market disciple. He views Obamacare as “insurance reform” that “doesn’t do anything to bend the cost curve that’s driving the cost of health care in the first place.” He wants consumer-based transparency.

Are Bucshon and his colleagues in a mode to begin to tweak and reform ACA components? “We are going to be in that mode of trying to address those things for a long time,” Bucshon said. “It’s going to be difficult.”

Drs. Brown and Bucshon are doing what public servants should be doing. They are in a learning mode and will scour an unhealthy state that is home to great research universities and pioneering health industries.

They know that Congress and the Indiana General Assembly are facing tough decisions that will have multi-billion-dollar implications impacting hundreds of thousands of Hoosiers.

Howey, a former Elkhart Truth reporter, publishes at www.howeypolitics.com. Find him on Twitter @hwypol.