INDIANAPOLIS | House Democratic Leader Scott Pelath, D-Michigan City, lashed out Friday at top legislative Republicans for not taking steps to decide whether Indiana should expand its Medicaid program under the new federal health law. 

"We cannot wait another day to start debating the great issue of our time, which is the Affordable Care Act and how do we cover every uninsured Hoosier," Pelath said. "We have not debated this, not even one day so far this session."

The health law, also known as Obamacare, requires states expand Medicaid eligibility to Americans earning up to 133 percent of the federal poverty level, which is $14,856 for an individual or $30,657 for a family of four. 

The federal government will pay the full cost of these new Medicaid enrollees through 2017 with the state's share gradually growing to a maximum of 10 percent for 2020 and beyond.

However, in upholding the constitutionality of the Affordable Care Act, the U.S. Supreme Court said states cannot be punished if they do not expand Medicaid eligibility. Republican Gov. Mike Pence has said he'll support expansion only if the federal government allows Indiana to run Medicaid its way, which is unlikely to happen.

Pelath said failing to expand Medicaid will leave some 400,000 Hoosiers without health insurance and force hospitals to continue providing nearly $3 billion a year in uncompensated care.

"We all benefit from people not going to the emergency room," Pelath said. "Middle-class workers cannot afford to keep sending people there as their first order of health care."

He also pointed out that three of Indiana's top 10 employers are hospital chains and more patients with insurance will mean more jobs at those hospitals.

"This is the biggest jobs measure we could possibly consider," Pelath said. "There's a potential for thousands of private-sector, good-paying jobs if we implement things fully — the kinds of jobs you can raise a family on."

Senate Democratic Leader Tim Lanane, D-Anderson, said all of Indiana's neighboring states, even those led by Republicans, plan to expand Medicaid eligibility. He asked why federal tax dollars paid by Hoosiers should provide health care in those states and not Indiana.

"I don't think we want to be known as the island of the uninsured," Lanane said. "We need to move forward with a real plan."

State Sen. Karen Tallian, D-Ogden Dunes, has sponsored Senate Bill 540, which expands Medicaid under the rules of the Affordable Care Act. But that legislation is not scheduled for a committee hearing prior to this month's deadline for Senate committee action.

Two Republican lawmakers said Friday they plan next week to amend other legislation awaiting committee action to include Medicaid expansion language. The text of those proposed amendments won't be available until Tuesday.

Pelath said House Democrats plan to press the issue over the next two weeks to compel the Republican majority to at least debate Medicaid expansion.

"We're going to use every opportunity we can in committee and on the (House) floor, not just to force votes but to force discussion. If the other side believes they have better ideas, then they need to start talking about them," Pelath said. "If they need to complain about it the whole time they're doing it, that's OK as long as it gets done."

An Indiana resident currently must earn less than 22 percent of the federal poverty level — that's $2,457 for an individual or $5,071 for a family of four — and have limited assets to enroll in Medicaid.

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