Our Own Desert Island

By Sheila Kennedy

[Originally published at SheilaKennedy.net on November 19, 2013]


Later today–between I:00 and 2:00 pm– there will be a rally at the Indiana Statehouse on behalf of the nearly 400,000 Hoosiers who find themselves marooned on Indiana–the island of the uninsured. 

States surrounding us, Republican and Democrat, have opted to take advantage of the new federal incentives and expand Medicaid. Not Indiana. Our Governor has decided that political posturing trumps the health needs of Indiana citizens who work in retail, education, home health, child care and other low-wage jobs without benefits. These are the people who are caught in the middle, who are too poor to use the new exchanges but too “rich” to qualify for Indiana’s existing medical programs. 

It’s pretty obvious that refusing to expand Medicaid effectively screws over these 400,000 Hoosiers. What is less obvious–and even more maddening–is how that refusal screws over the rest of us. 

  • If a state expands its Medicaid coverage, the federal government will pay 100% of the costs for the first three years and 90% thereafter. Indiana is forgoing approximately twenty-six billion dollars between now and 2020–dollars that would create an estimated 30,000 sorely needed new jobs in our state. 
  • The American Academy of Actuaries says that private insurance costs will rise in non-expansion states like Indiana. Local media has reported that Hoosiers are already seeing rates higher than the rates in states that surround our “island.” 
  • The federal money we are turning down would offset expenses for indigent care and prison health care that are currently being covered by Indiana taxpayers. 

Medicaid expansion would save money while saving lives and improving the health of our citizens. It would provide access to preventative care to those who are currently uninsured, reducing the tab for healthcare costs overall, including those that we taxpayers are now paying. 

I know you’ll all be shocked to discover that Indiana currently ranks near the bottom of all states for most health indicators. In a sane world, we would jump at the opportunity to improve Indiana’s health and its economy. 

Governor Pence’s refusal to expand Medicaid has already forced significant layoffs by Indiana hospitals, which have argued forcefully–but thus far unsuccessfully–for expansion. Other states with Republican governors have done the math and decided that the good of their citizens should trump their hatred of the President. 

This should be a no-brainer. 

I’ll forego the obvious pun.


Sheila Kennedy is a former high school English teacher, former lawyer, former Republican, former Executive Director of Indiana's ACLU, former columnist for the Indianapolis Star, and former young person. She is currently an (increasingly cranky) old person, a Professor of Law and Public Policy at Indiana University Purdue University in Indianapolis, and Director of IUPUI's Center for Civic Literacy. She writes for the Indianapolis Business Journal, PA Times, and the Indiana Word, and blogs at www.sheilakennedy.net. For those who are interested in more detail, links to an abbreviated CV and academic publications can be found on her blog, along with links to her books..

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