Like it or not, Obamacare is going to require changes in how health care is funded in Indiana, just as elsewhere in the nation.
The Indiana Hospital Association cited its study by the University of Nebraska that found expanding Medicaid in Indiana would generate $3.4 billion in economic activity and create 30,000 jobs.
The federal Affordable Care Act requires states to expand Medicaid eligibility to Americans earning up to 133 percent of the federal poverty level, which translates to $14,856 for an individual or $30,657 for a family of four.
There's a catch for states, though. Their share of the cost of this care would gradually increase to a maximum of 10 percent for 2020 and beyond.
According to the study, 406,000 uninsured Hoosiers would qualify for Medicaid if the guidelines were expanded. That would boost federal health care spending in Indiana by $10.45 billion between 2014 and 2020 while costing the state $503 million.
The Indiana Hospital Association is pushing for Medicaid expansion, citing not only the benefit to its 164 member hospitals, but also to patients with private insurance. The study figures reducing the number of uninsured Hoosiers would cut hospitals' losses for uncompensated care by $3 billion a year. That would reduce premiums for private insurance because fewer patients would receive health care without paying for it.
Like the hospital association, House Minority Leader Scott Pelath, D-Michigan City, wants to see state lawmakers discuss the possibility of Medicare expansion as the Indiana General Assembly crafts its biennial budget.
"We all benefit from people not going to the emergency room," Pelath said Friday. "Middle-class workers cannot afford to keep sending people there as their first order of health care."
Nor can Indiana wait to see what the federal government will do. And whatever Indiana's response to this health care puzzle ends up being, it's going to be costly.
This is a discussion that needs to happen, regardless of how Indiana ultimately addresses its responsibilities under the Affordable Care Act. Ignoring this challenge won't make it go away.