Editor's note
Joe Gomeztagle is this week’s guest on Who Gets What? He’s the man who initiated the complex move of changing Indiana’s obsolete property assessments toward a more fair system. It was a long and arduous journey for a man seeking equity for everyone. Hear Joe’s story on Who Gets What? where you get your podcasts or at mortonjohn.libsyn.com.
The Indiana General Assembly, which gets its share of bruises, is getting close to doing something very beneficial for a some very sick children, their parents and their siblings.

Hoosiers are fortunate to have the Riley Hospital for Children located in Indianapolis. It is nationally ranked in 10 children specialties. However, it is in Indianapolis. That’s not a bad thing, expect if you are poor and live in a corner of the state.

Imagine your family on Medicaid. Not Medicare, which is primarily for the older population, but Medicaid, the stepchild of health care in the United States. The Federal and State governments share Medicaid costs with the States anteing up 34 percent of the fees paid to health care providers.

Your family is very poor; if you weren’t, you wouldn’t qualify for Medicaid. You have just one old, not very reliable car, and one very sick child. To get a proper diagnosis and treatment plan for that child, the Indiana Family and Health Services Administration (FHSA) would have you go to Riley in Indianapolis.

But how far is Riley from the extreme reaches of the state? From Hammond (Lake County), Fremont (Steuben), Vevay (Switzerland), New Albany (Floyd), and Mt. Vernon (Posey)? In terms of distance, the average is 150 miles or 2:30 hours one-way. Double that to come home. Yes, 300 miles in an unreliable car and five hours on the road when there are closer alternatives in Chicago, Louisville and Cincinnati.

When there is a distinguished hospital in an adjoining state, that might be a better choice for the child, the parent(s) and any siblings. Last year, the Indiana Senate rejected a bill that would have granted parents that choice. Why? The out-of-state hospital might expect Medicaid reimbursement from Indiana FHSA at a higher rate, as approved in their state, than Indiana would approve. We do have a reputation for being cheap.

How much money are we talking about? The Indiana Legislative Services Agency (LSA), recognizing that an exact estimate was not possible, advised “Indiana’s state share … would be between $300,000 and $950,000.”

You’ll be proud to hear the bill passed the House by a vote of 93 to 0. Now it rests with the Senate. In fiscal terms, this proposal is hardly to be noticed in a total budget of $36 billion as passed by the House.

Rep. Hal Slager (R-Schererville) and Sen. Mike Bohacek (R-Michigan City) introduced HR-1305 to enable Hoosier families to use out-of-state hospitals to treat their children when circumstances require such action. They have been joined by Reps. Soliday (R-Valparaiso), Clere (R-New Albany) and Olthoff (R-Crown Point), as well as Sens. Charbonneau (R-Valparaiso), Niemeyer (R-Lowell) and Tallian (D-Ogden Dunes).

When passed by the Senate, this will be a major benefit to poor Hoosier families caring for extremely sick children.
Morton J. Marcus is an economist formerly with the Kelley School of Business at Indiana University. His column appears in Indiana newspapers, and his views can be followed his podcast.

© 2024 Morton J. Marcus

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