Tuesday, November 25, 2014

Indiana's Pence takes a pragmatic approach to Obamacare

Pence didn’t necessarily embrace the Obamacare he vociferously rejected as a congressman, but instead sought its adaptation with what could be called the compassionate, conservative stamp.

Posted on May 22, 2014 at 3:42 p.m.

INDIANAPOLIS – When the early historical accounts of Mike Pence’s first stint as a governor are assembled, the critical moment will likely be 10 a.m. May 15, 2014.

At that time, at the IU Health/Methodist Hospital Auditorium, Pence pushed away from the ideological trappings of a Capitol Hill Republican and became a pragmatic governor. His was not an embrace of Obamacare, but a critical mass realization that he presides over an unhealthy state and to reject Obamacare outright would only continue a troubled Hoosier Jacksonian legacy that thumbs its nose at federal funding, often at great expense to its citizens decades later.

We have seen this happen before. The spurning of the school lunch program in the 1950s, Nixon-era federal revenue sharing, and a failure to separate combined storm and sanitary sewers a generation ago spawned a wave of double-digit rate hikes in dozens of Indiana cities.

The scenario facing Pence was hundreds of thousands of Hoosiers without access to health insurance, coming at a time when the state suffers high obesity, smoking, infant mortality, adult suicide, coronary and cancer rates. “The facts are clear,” Pence said. “Today we have 350,000 low-income, working Hoosiers, those below 100 percent of the federal poverty level or a family of four making about $24,000 a year or less, who lack access to the kind of quality health insurance that their better-off neighbors enjoy. Experts rightly call this the ‘coverage gap.’”

Pence didn’t necessarily embrace the Obamacare he vociferously rejected as a congressman, but instead sought its adaptation with what could be called the compassionate, conservative stamp.

“I believe there are only two futures for health care in this country, government-directed health care or consumer-driven health care,” Pence said. “Indiana chose the better portion by embracing consumer-driven health care, giving eligible Hoosiers the power to make their own health care decisions. Today we seek to build on that choice by expanding the Healthy Indiana Plan for even more working Hoosiers.”

And as the assembly watched what many had thought would be an unlikely event, Pence brought a measure of his soul, which many Hoosiers admire. “Let me speak from my heart,” he said, as the four Hoosiers he cited with their own health care dilemmas sat amongst the state’s powerful legislators in the first row. “Hoosiers have long cherished the principle that we must love our neighbor as we love ourselves; that we must not walk by on the opposite side of the road when our neighbors are hurting and in need. That’s what makes Indiana special.”


This moment became a virtual “we are the world” synapse. There was conservative Curt Smith of the Indiana Family Association, saying, “As I watched his remarks and saw the broad support in the room (hospital execs, docs, other health care professionals, elected officials, budget hawks, and more) it became obvious this proposed expansion of the Healthy Indiana Plan puts Indiana in the forefront of providing an alternative to Obamacare.”

State Rep. B. Patrick Bauer, D-South Bend, observed, “I’m glad he’s giving it another effort and I hope he succeeds. There are a lot of people in this state that don’t have health care.”

What many expected, however, was Pence to simply reject Obamacare outright. The danger in that was that with repeal virtually impossible, the Obamacare mandates would still be there, the funding wouldn’t.

U.S. Rep. Larry Bucshon and House Ways & Means Chairman Tim Brown observed in an op-ed article for the Lafayette Journal & Courier, “As physicians, we have a core principle belief that every citizen should have the opportunity to access quality, affordable health care. The governor’s plan puts patients in the driver’s seat and requires them to have skin in the game to receive additional benefits, while protecting a basic plan that covers all enrollees. The plan is budget neutral; it does not pay for expansion on the backs of Hoosier taxpayers and does not rely on resources from the general fund.”

Speaking Monday before the American Enterprise Institute, Pence affixed the badge of pragmatism to his jacket. “When it comes to the issue of health care, I believe that people in my party need to be solutions conservatives, offering real alternatives to the big-government answers

There will be tough days and big decisions ahead on the “intractable problem” front.

A source familiar with the Family Social Services Administration reacted by saying, “The major sticking point with (Center for Medicaid/Medicare Services) has been that under the current HIP plan enrollees who fail to make contributions to their POWER accounts would lose coverage.” Now they won’t.

But that source added, “I am convinced that the implementation of this plan will be a disaster. The current HIP is poorly run and the POWER account administration is a disaster. This implementation could be as bad as the Obamacare rollout and Pencecare will give the Dems a lot to shout about.”

Successful governors are those who rule with pragmatism. They are confronted with, as Pence observed, “real people” facing “intractable problems.”

There’s a long way to go for this story to play out. But there is no mistaking that Pence opened a new chapter in his policy career. And as the old saying goes, good policy makes good politics.

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

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