INDIANAPOLIS — Gov. Mike Pence announcing he’ll ask for federal dollars made possible by Obamacare to insure hundreds of thousands of Hoosiers is the first real political gamble the Republican has taken while in office.
The potential expansion is reaping heavy praise in the Hoosier state from Democrats and Republicans alike. The plan could insure 350,000 Hoosiers who can’t get health coverage anywhere else. The human impact is immense, with House Democratic Minority Leader Scott Pelath saying, “We have always said if (Pence’s) way works, we will not dicker over the details.”
So far, Pence has taken modest actions to add to his already conservative pedigree modest tax cuts and modest expansion of educational choice. If the federal government approves of Indiana’s plan, Pence’s decision to access as much as $16.5 billion in federal dollars through the Affordable Care Act will have by far the most influence on the state.
But will it pay off?
As speculation grows that Pence will be among Republican presidential contenders in 2016, his decision to align the state’s health program to the requirements to receive those federal dollars is a matter of risk and reward.
The risk is angering some of the most conservative members of his base who see an expansion of the state’s Healthy Indiana Plan as an expansion of Medicaid.
The Heritage Foundation an influential body in Republican politics called Pence’s decision a disappointment and accepting the funds as a “dangerous proposition” because of cost uncertainty and the potential for the waiver to not provide the flexibility the state desires to deliver an expanded Healthy Indiana Plan as opposed to traditional Medicaid. Pence’s office did not return a request for comment Friday on those concerns.
The reward is clear -- Pence selling a conservative approach to the real problem of uninsured Americans. Unlike traditional Medicaid, the proposed expansion will require participants to make monthly contributions to retain coverage. The poorest Hoosiers aren’t required to make monthly payments but will have copays. Pence has billed the approach as consumer driven and not as an entitlement program.
“If Pence runs for president in 2016, some of his opponents will probably attempt to portray him as having gone along with Obamacare by opting to expand Medicaid in some fashion,” said Geoffrey Skelley with the University of Virginia Center for Politics.
Yet, Skelley noted some other potential Republican contenders Govs. John Kasich of Ohio and Susana Martinez of New Mexico have already expanded Medicaid.
“That makes the attack less likely to stick on Pence,” Skelley said, “especially if he continues to portray himself as a basic opponent to Obamacare, which he seems to be doing.”