Indiana’s top lawmakers signaled Monday that Republican Gov. Eric Holcomb’s public health recommendations – which include $243 million in additional health care spending annually – would face a tough crowd in the General Assembly.
He spoke at the Indiana Chamber of Commerce legislative preview, ahead of the January session that will include drafting the state’s next two-year budget.
GOP Senate President Pro Tempore Roderick Bray said of the hefty price tag, “I find it a little hard to swallow.” He said local health departments may not even be able to handle that much money at once, even if lawmakers were to authorize it.
“I think it’s going to be difficult,” Bray said, to fund the total $480 million request in the budget. Instead, that number is “a good place to work,” and Indiana will focus on infrastructure to implement those changes in the meantime.
But he also expressed doubt that the broad recommendations would help reduce health care costs, which he said is a priority.
House Speaker Todd Huston, R-Fishers, said Indiana already invests in public health — though “it may not be as much as people would like” — and if Indiana adds more money, it needs to be “measurable.” Actionable goals must be supported with results.”
Indiana ranks 48th in the nation for public health funding, spending about $55 per Hoosier on public health initiatives, or $36 less than the nationwide average of $91 per person.
Huston said he had asked Rep. Brad Barrett, R-Richmond, chairman of the public health committee, and Rep. Jeffrey Thompson, R-Littzon, chairman of the Ways and Means Committee, to do a “deep dive” of the 107-page report — though He didn’t make any promises on the results of those analyses.
“some [recommendations]Not all will be successful — or certainly entertained,” Huston said.
taking it seriously
Top Democrats in the General Assembly pushed back.
House Minority Leader Phil Giaquinta, D-Fort Wayne, said, “When it comes to health care in this state, we have a lot of problems here, and the cost of health care is clearly one of them.” “… I think it signals that we are not taking the issue seriously enough if we don’t actually follow the recommendations.”
Senate Minority Leader Greg Taylor, D-Indianapolis, when Huston said that, “first and foremost,” Hoosiers can improve health care outcomes by taking personal responsibility.
“I think that’s the problem we’ve seen in the last 20 years of leadership in the state of Indiana,” Taylor said, referring to GOP governance. “Access to health care is the first step.”
The government, Taylor said, is heavily involved in the development and approval of new drugs and should not be bent on pricing.
The report’s architects — state health commissioner Dr. Chris Box and former state Senate appropriations committee chairman Luke Kenley — said they hope their work will be translated into law at an unveiling in August.
“We need to be able to remove the skepticism,” said Sen. Ed Charbonneau, R-Valparaiso, chairman of the Senate Health and Provider Services Committee at the time.
(health) getting down to specifics
Although the four legislative leaders also spoke on the budget, education and more in Monday’s hour-long Q&A, they spent most of the time on health care and affordability. Lawmakers offered several specific solutions, but cast doubt on others.
– Cigarette tax: The chamber has long supported an increase in Indiana’s cigarette tax to prevent smoking — tobacco use and its negative health effects cost Hoosier employers $6 billion annually, according to the organization. It’s gunning for the $2 bump, or as low as $1.
Huston’s chamber has passed such legislation before, but it didn’t move past the Senate — and he didn’t expect that to change, calling the increase “highly unlikely.”
Bray said his caucus would seek to boost Indiana’s health care metrics and restructure public funding based on Holcomb’s commission, but was non-committal on changes to the cigarette tax.
, nurse practitioners: The chamber outlined just one legislative priority related to health care in a news release Monday: to address provider shortfalls by broadening scope of practice laws to “low-level” providers such as nurse practitioners — And possibly mid-level ones.
Huston said the solution was too narrow for such a widespread access problem, and said he wanted more independent primary care physicians, rather than hospital-affiliated ones.
Bray also expressed doubts.
“You’ll need to show me, to convince me that, one, it’s actually less expensive, not more expensive,” Bray said, to have nurse practitioners perform some of the same duties as doctors. He also wants to examine data from other states that have tried similar changes to ensure that nurse practitioners there have moved to rural parts of the state where there is a shortage of doctors.
, abortion and moreAfter the event, Huston told reporters that his caucus would “go pat” on abortion rather than pursue a more restrictive effort on Indiana’s near-total abortion ban. And he said there could be a movement toward wider access to contraceptives.
, mental healthHuston suggests raising reimbursement rates for mental health services to address the shortage of professionals.
This story by Leslie Bonilla Muniz is republished from The Indiana Capital Chronicle, an independent, nonprofit news organization that covers state government, policy and elections.