Tag Archives: medicaid

Letter to Governor: Urging the Approval of Medicaid Expansion [1 of 3]


March 18, 2013



brouillette The Honorable Mike Pence
Governor of Indiana
Room 206
State House
Indianapolis, IN 46024


Dear Governor Pence,

Thank you for your service to the State of Indiana and your commitment to improving the quality of life for all Hoosiers. I remember from your leadership in vespers and bible study while we were both at Hanover College that you are committed to giving witness to your Christian faith through the beliefs you espouse and the decisions you make.

After graduating from Hanover, I worked for Senator Richard Lugar as his Assistant State Director for Constituent Services. When Senator Lugar left office in January, I joined the staff of Lafayette Urban Ministry.   I am writing you in my new capacity as Program Director for Healthy Families and Sustainable Communities to urge you to approve Medicaid expansion.  As you are no doubt aware many hardworking families are not able to afford health care coverage and are often forced to choose between feeding their children and seeking medical treatment.  Most of the 450,000 Hoosiers who would be helped by Medicaid expansion work at least two jobs but still earn less than 133% of poverty ($31, 322 for a family of four). They are disqualified from basic Medicaid for being responsible and doing exactly what we expect them to do: work.

I realize that you have already been briefed on arguments in support of Medicaid expansion such as stimulating the life sciences sector of our economy, creating 30,000 jobs, holding down hospital costs by insuring an additional 450,000 Hoosiers, and capturing our portion of the federal funding from the Affordable Care Act.  The purpose of my letter, however, is to discuss the moral and theological implications rather than the fiscal and political considerations.

I am interested in knowing how you reconcile the implementation of the Affordable Care Act with your theological beliefs.  For me the incarnation is a reminder to us that God takes seriously our physical as well as our spiritual wellbeing.  The Bible tells us that Jesus did not just restore peoples’ souls but also made them physically whole.   In Matthew 25 31-46 Jesus tells us that it is the powerful not the hungry, the thirsty, or the sick that are being judged.   In a complete turnabout, the King of Kings, Lord of Lords identifies himself three times with those who have the least.  The Bible also says in Luke 12:48, “From everyone to whom much has been given, much will be required, and from the one whom much has been entrusted, even more will be demanded.”  In Matthew 25 Jesus does not outline a litmus test to determine who is truly needy except to say, “As you did it to one of the least of these who are members of my family, you did it to me.”  Since Jesus does not set any conditions for determining need, it would seem that it is our obligation to care for people according to their need.  Rather than lifting up the poor as the Gospel suggests, enormous time and energy has been spent to deny, demoralize and demonize them. We Christians would be well served to heed the warning found in Matthew 7:7, “Do not judge, so that you may not be judged”.  For with the judgment you make you will be judged, and the measure you give will be the measure you get.”

 Having been duly elected, you have been appointed to be a good and faithful servant to ALL of the people of Indiana.   God has put you in the position you are in not to do what is easy or politically expedient, but to think outside the box and consider what is just according to His will without regard to personal gain or political expediency.   I urge you to shift your thinking regarding Medicaid expansion in a direction that not only sees, but honors the image of Christ in every low-income man, woman, and child.  You mentioned in your reflection at the Indiana Leadership Prayer Breakfast that we need to be mindful “not to stand in the way of God’s attempt to answer someone’s prayer.” I wonder if God is speaking through petitions such as these not to stand in the way but to help the 450,000 working families in Indiana who would be helped by Medicaid expansion.

Thank you for your review of these concerns.  Please include in your response the theological basis for your position.   Thank you.

Sincerely,

brouillette signature

Susan Brouillette
Program Director for Healthy Families and Sustainable Communities
Lafayette Urban Ministry
420 N. 4th Street
Lafayette, Indiana 47901-2213


NEXT:

READ Indiana Governor Mike Pence’s Response to Susan Brouillette (May 1, 2013), click HERE.


To READ Susan Brouillette’s Second Letter in Response to Governor Pence (May 20, 2013), click HERE.



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Governor Pence’s Response to LUM [2 of 3]


governorpenceletterhead

May 1, 2013


Ms. Susan K. BrouilletteMike_Pence,_official_portrait,_112th_Congress
Program Director, Healthy Families & Sustainable Communities
Lafayette Urban Ministry
420 North 4th Street
Lafayette, IN 47901-1112


Dear Ms. Brouillette,

Thank you for contacting me regarding implementation of the Affordable Care Act in Indiana.  It was a pleasure to hear from you.

As you may know, I opposed passage of the Affordable Care Act and support its repeal.  This law threatens to increase the cost of health insurance premiums, stifle economic growth, and diminish Indiana’s sovereignty.  Despite my opposition to the Affordable Care Act in principle, I understand and respect that some Hoosiers believe that Indiana should fully participate in its implementation.

With regard to the establishment of a state-based health insurance exchange, there is quite simply too much uncertainty to justify moving forward at this time.  The way the regulations are currently written, Indiana would be forced to cover the over $50 million in costs per year to operate an exchange controlled by a wide array of federal regulations.  Furthermore, it is not clear that this investment would lower health insurance premium costs.  For these reasons, the State of Indiana is inclined to leave the establishment of a health insurance exchange in the hands of the federal government.

Indiana will also not be moving forward with an expansion of our current Medicaid program per the Affordable Care Act.  To do so, in my view, would be to expand a broken program in Indiana and place an enormous burden on Hoosier taxpayers.  The State’s actuary estimates that a Medicaid expansion could cost upwards of $2 billion over the next seven years.  We should not be simply seeking to put more people on the State’s Medicaid rolls.  The goal of Medicaid is to provide health care for the neediest, but it also should empower recipients to more toward self-sufficiency.

Indiana is fortunate to have the Healthy Indiana Plan, a consumer directed alternative to Medicaid that has proven ability to meet this goal and has shifted the Medicaid paradigm in Indiana.  Our administration strongly supports the bipartisan-created Healthy Indiana Plan and has asked to continue it for the 40,000 current enrollees.  We have also renewed the state’s request to waive Medicaid’s rules so that the Healthy Indiana Plan may be considered as a vehicle to bring health care coverage to more Hoosiers.  I have made it clear to U.S. Health and Human Services Secretary Kathleen Sebelius that any discussion of a coverage expansion must begin with the Healthy Indiana Plan.

Indiana and other states need the freedom and flexibility to develop health care solutions that best meet the needs of our citizens, without interference from Washington.  We must face our challenges in health care with a belief in more freedom, not more government.

Sincerely,

pencesignature

Michael R. Pence
Governor of Indiana
Room 206
State House
Indianapolis, IN 46024


NEXT:

READ Susan Brouillette’s Second Letter to Governor Pence (May 20, 2013), click HERE.


To VIEW Governor Mike Pence’s original letter (PDF) — Response to Susan Brouillette (May 1, 2013), click HERE.

To READ Susan Brouillette’s Initial Letter to Governor Pence (March 18, 2013), click HERE.



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Second Letter to Governor: Urging the Approval of Medicaid Expansion [3 of 3]


May 20, 2013



brouillette

The Honorable Mike Pence
Governor of Indiana
Room 206, State House
Indianapolis, IN 46024


Dear Governor Pence,

I received your response last week regarding the letter I sent you in March asking you to support health insurance coverage for the working poor and underemployed Hoosiers who make at or below 133% of poverty.   I was pleased to learn that you are willing to accept the 10.45 Billion in federal funds set aside for Indiana under the Affordable Health Care Act under the auspices of the Healthy Indiana Plan as opposed to traditional Medicaid.   However, I am concerned that your administration appears to be willing to put at risk low income Hoosiers, economic development opportunities, and revenue offsets in order to claim a political victory rather than a moral one.  By sending the federal government proposals that violate the spirit of the ACA, Indiana is gambling with its share of the dollars set aside under the Affordable Care Act and driving up the costs of health care for those of us lucky enough to be insured.   It is true that after 3 years Indiana will have to pay a 10% match, but that could easily be covered by the proceeds the State receives from the Tobacco settlement and/or the money that had previously been allocated to state high risk insurance.   According to Matthew 5:42,”we are to give to him who asks of you and not to turn away from him who wants to borrow from you.”   I understand that you are endeavoring to be a good steward, as you should, but should it not be secondary to trusting God and God’s will?  Should we not expect Christian office holders to keep the public trust by at the same time putting their trust in the word of God?

In my earlier letter I appealed to the friendship we had in Christ while at Hanover as well as the Christian discipleship that has been the centerpiece of your public life.  Unfortunately, however, you shied away from expressing how your faith walk relates to your decisions as an elected office holder and the way you balance competing interests in light of the Gospel.  I would have liked to hear from you how you interpret versus such as Luke 12:48 and Mathew 25:45 and what they say regarding our shared responsibility to care for the least among us.   Drawing upon Isaiah 24:4, do you believe there are exceptions to God summons to be a “defense for the helpless, a defense for the needy in distress?” Whereas you have publicly stated a penchant for using Christian ethics as the standard to order other parts of public life, why would it not be the same with respect to the summons in Deuteronomy “If anyone is poor among your fellow Israelites in any of the towns of the land the LORD your God is giving you, do not be hardhearted or tightfisted toward them”?

Once again I am requesting to know how your faith informs your position regarding the implementation of health care coverage for the working poor.   I look forward to receiving your reply.

Sincerely,

brouillette signature

Susan Brouillette
Program Director for Healthy Families and Sustainable Communities
Lafayette Urban Ministry
420 N. 4th Street
Lafayette, Indiana 47901-2213
www.lumserve.org
765.423.2691


To READ Susan Brouillette’s First Letter to Governor Pence (March 18, 2013), click HERE.

To READ Governor Mike Pence’s Response (May 1, 2013) to Susan Brouillette’s First Letter (March 18, 2013), click HERE.



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Guest Column: Indiana can’t afford to sidestep Medicaid question


June 5, 2013



brouilletteThe Indiana General Assembly unfortunately adjourned without providing a framework for a Medicaid expansion plan. While it does set aside $250 million in a Medicaid Reserve Account, the “hands off approach” could cost the state $10.5 billion.

Instead of positioning the state to leverage the funds, Gov. Mike Pence has signaled a preference for submitting rote plans that are irreconcilable with the spirit of the Affordable Care Act. The rationale for the Affordable Care Act is that by enrolling everyone in some type of managed care plan, we will stop incentivizing emergency room visits. As a result we will be able to save billions of dollars by controlling costs and reducing chronic illnesses, such as diabetes and heart disease.

A limited expansion of Medicaid was supposed to be the thread that would sew up the safety net by providing coverage to people earning 133 percent of poverty or less. According to the Health and Human Services Poverty Guideline for 2013, a four-person family earning $31,322 or less is considered to be at the poverty level.

Most of the 363,000 Hoosiers who would be helped by Medicaid expansion work at least two jobs but are not eligible for health care coverage through their employers or cannot afford to pay their share of the premium. According to the Centers for Medicaid and Medicare, nearly 21,000 residents in Greater Lafayette and surrounding counties would be helped by Medicaid expansion, in turn reducing the burden on businesses and charitable organizations that currently pick up the tab.

The future of the Affordable Care Act is no longer a matter of debate. The long-needed overhaul of our health care system is underway and will soon be the new reality. The private health care industry, which runs the gamut from your family doctor to your insurance agent, has already spent billions of dollars changing the way it does business. If you don’t believe me, ask any IU Health Arnett or St. Elizabeth hospital employee how their organization has restructured to accommodate the Affordable Care Act. We will undermine the investment and hurt ourselves by not extending health care coverage to all Hoosiers.

The Affordable Care Act and Medicaid expansion, in particular, will benefit Indiana residents beyond improved access to health care. The return on the 10-year investment of $537 million is expected to be gigantic. The federal money will generate $108 million in new state and local tax revenue per year, stimulate the life sciences sector, pump between $2.4 billion and $3.4 billion into the state’s economy, create 30,000 jobs across all sectors of the economy by 2020 and hold hospital costs by insuring an additional 400,000 Hoosiers. On the flip side, under the Affordable Care Act, “disproportionate share” payments allotted to hospitals that serve low-income patients will be cut, shifting the burden to other consumers of the services. Hence, if the state fails to act we will be paying twice for the same services without receiving any benefit.

By being concerned more with politics than leadership and sending the federal government proposals incompatible with the act, Indiana risks forfeiting its fair share of the dollars and driving up the costs of health care for those of us lucky enough to have insurance. It is true that after three years Indiana will have to pay a 10 percent match, but that could easily be covered by the proceeds from the tobacco settlement or the money that had previously been allocated to state high-risk insurance programs (which is expected to be dissolved).

Unfortunately, the General Assembly sidestepped an opportunity to divert emergency room visits and ensure that a population already at high risk for disease receives treatment before short-term illness turns into something more permanent.

Please contact your representatives in the Indiana General Assembly as well as Gov. Pence if you believe the state should not delay any longer and position itself to claim the $1.7 billion already authorized under the Affordable Care Act for 2014.

Sincerely,

brouillette signature

Susan Brouillette
Program Director for Healthy Families and Sustainable Communities
Lafayette Urban Ministry
420 N. 4th Street
Lafayette, Indiana 47901-2213
www.lumserve.org
765.423.2691


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Cover Indiana

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  • Are you or someone you know without health insurance?
  • Do you know anyone who has filed bankruptcy because of medical bills?
  • Do you know friends who chose between a doctor visit or medicine and rent, utility, or food?

Indiana policymakers are debating whether and how to provide access to healthcare coverage. Indiana has the opportunity to expand Medicaid to low-income Hoosiers (with annual incomes of up to $11,170 for a single adult, or up to $23,050 for a family of 4).

Tell your story. Go to www.coverindiana.org or complete a postcard today.

coverindiana



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