HEALTHCARE

Indiana spends far less on public health measures than the national average

or our neighboring states. This lack of investment compounds health problems.

Indiana has especially high rates of:

maternal mortality
infant mortality
smoking
hospital closures
mental health conditions
cardiovascular disease
drug overdoses and suicides

According to a 2020 Indiana University Fairbanks School of Public Health Report, “the average Hoosier is sicker and suffers from more health conditions than the average American.”

EQUITABLE & ACCESSIBLE HEALTHCARE

Click the image to view MADVoters Healthcare Advocacy Series, or download a PDF version here.

MADVoters affirms that access to affordable, quality healthcare is a human right.
We advocate for policies that will:

Lower healthcare costs, make healthcare more affordable, improve transparency, protect Medicaid and Medicare access, and reduce the burden of medical debt.
Ensure everyone can access good quality, evidence-based healthcare by protecting public health initiatives and addressing hospital closures and care deserts.
Defend bodily autonomy, including reproductive freedom and gender-affirming care.

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TALKING POINTS

MEDICAID

Indiana Medicaid covers a wide range of healthcare for over 2 million low-income people, foster children, disabled people, and the elderly in Indiana. Over 2 million Hoosiers utilize Medicaid. It is a federally-funded program that is administered by the state. Medicaid waivers, HIP, and Hoosiers Healthwise are some Medicaid programs.

Trump’s “Big Beautiful Bill” (HR 1) slashed federal funding for Medicaid, which will force states to pick up the tab or cut services. The BBB cut $31 billion from Indiana Medicaid, including almost $13 billion in hospital funding, over the next decade. More specifically, the “Big Beautiful Bill” reduces reimbursements for Medicaid patients, reduces tax dollars available to hospitals, increases expensive, bureaucratic processes for hospitals,and will increase uninsured rates.

Indiana will have the 7th highest total dollar impact (only 6 states will have higher cuts).
180,000 Hoosiers are estimated to lose their Medicaid coverage.
A dozen Indiana hospitals are forecast to be considerably impacted by HR 1.

In addition to the federal funding cuts, recent state laws like 2025 SEA 2 and 2026 SEA 1 have added more eligibility checks and work requirements to Medicaid, which increase administrative cost and burden, as well as the risk of disenrolling eligible patients due to administrative error.

Sources: indianacapitalchronicle.com/2025/07/14/medicaid-cuts-all-hoosiers-will-feel dailyjournal.net/2026/01/30/feeling-the-pain-indiana-hospitals-facing-unsure-financial-future

HOSPITAL CLOSURES & CARE DESERTS

Nearly 20% of Indiana’s counties - all in rural areas - don’t have a single hospital. Half of our counties only have one hospital. These care deserts mean patients have to travel farther for care, which can contribute to delays in care and adverse outcomes. When hospitals downsize or close, it compounds those problems, and also reduces local jobs.

42% of Indiana’s rural hospitals no longer provide labor and delivery services. Since 2020, 16 OB departments have closed in Indiana, nearly all in rural communities.

In Indiana, Medicaid reimburses hospitals for just 57% of the care of costs. Low Medicaid reimbursement rates are a major contributor to hospital closures, especially in rural areas, because they are paid less than the cost of providing care, leading to financial strain on providers. These Medicaid base rates haven’t seen a significant increase in 30 years.

Sources: https://indianacapitalchronicle.com/2023/02/13/rural-hospitals-worry-as-lawmakers-move-to-lower-costs-for-patients, https://www.wthr.com/article/news/local/johnson-memorial-health-hospital-to-close-its-maternity-care-center/531-f3d83c24-73e8-4352-a6a3-8df98609e14d, wfyi.org/news/articles/report-finds-more-than-half-of-rural-hospitals-no-longer-deliver-babies, indianacapitalchronicle.com/2025/07/14/medicaid-cuts-all-hoosiers-will-feel

AFFORDABILITY

Indiana ranks poorly for healthcare affordability. Hospital prices, medication prices, and medical debt are highest both in the Midwest and across the nation. Indiana’s Medicaid reimbursement is ranked in the bottom quarter.

Roughly one in five Hoosiers has medical debt currently in collections - about a $2 billion burden. This is the highest in the Midwest, with the rate disproportionately high in rural areas and among communities of color.

Recent antitrust laws that increase hospital oversight (2025 HEA 1004), prohibit physician noncompete agreements (2025 SEA 475), and pharmacy benefit manager (PBM) reforms (2025 SEA 140) have made some improvements, but significant systemic change is lacking. Lawmakers have passed laws that increase oversight of Medicaid patients — adding administrative costs and burdens — but haven’t improved accountability and transparency

Sources: https://institute.incap.org/medical-debt, https://employersforumindiana.org/indiana-hospital-prices-remain-high

INDIANA'S ABORTION BAN

Indiana banned abortion in 2022. The ban goes into effect from the moment of conception. Indiana was the first state after Roe v. Wade was overturned to pass an abortion ban.

The “exceptions” in which an abortion is legal in Indiana are limited. Proving that a patient meets these exceptions can delay care, causing worse outcomes, including sepsis, infertility, or death. Very few patients who qualify for an abortion can access this care, as abortions may only be performed at hospitals (no clinics), and most hospitals in Indiana won't perform them. The exceptions include:

Up to 10 weeks post-fertilization for rape/incest. But forcing survivors to “prove” their assault in order to qualify for an exception is incredibly cruel and compounds their trauma.
Up to 20 weeks post-fertilization for pregnancies with fatal fetal anomalies. However, many anomalies are not detected until the 20-week anatomy scan - by that time it is too late to arrange for an abortion.
To protect the life or health of the mother. This is a subjective decision that requires the mother to “prove” that she is ill or injured enough to qualify for the exception.
A religious freedom exemption is currently moving through the courts.

Studies show that states with abortion restrictions have higher rates of maternal and infant deaths and fewer maternity care providers.

Sources: mirrorindy.org/indiana-abortion-laws-exceptions-rape-religious-freedom-pills-caitlin-bernard, https://indianacapitalchronicle.com/2023/08/30/hospitals-close-lipped-on-post-rape-abortion-policies/, http://commonwealthfund.org/publications/issue-briefs/2022/dec/us-maternal-health-divide-limited-services-worse-outcomes

CRISIS PREGNANCY CENTERS (CPCs)

Pregnancy Care Centers, also known as crisis pregnancy centers (CPCs), counsel pregnant women against abortion. But CPCs are not healthcare providers. These often religious-affiliated organizations are not regulated or licensed, and are typically run by non-medical volunteers. Because they aren’t actual healthcare providers, they don’t have to follow patient privacy laws like HIPAA. CPCs often use shame, fear, and disinformation to prevent patients from accessing abortion care and other reproductive health services.

Sources: https://indianacapitalchronicle.com/2026/03/05/repub/taxpayer-dollars-flood-pregnancy-centers-oversight-hasnt-followed/

MATERNAL MORTALITY

Indiana has the 3rd highest maternal mortality in the United States. In Indiana, Black women have a 93% higher maternal mortality rate than white women, according to the Indiana Department of Health.

Black patients face systemic racism and barriers to their healthcare, like having their concerns and symptoms dismissed, difficulty accessing care, and less access to insurance coverage. This can contribute to complications, chronic problems, and even death. Preeclampsia is the leading cause of Black maternal death.

Sources: apa.org/monitor/2023/06/abortion-bans-harm-people-of-color, wishtv.com/news/multicultural-news/indiana-maternal-mortality-rates