SB2 Puts the Health and Lives of Hundreds of Thousands of Hoosiers at Risk

Like millions of Americans, I have a story that shows the negative impact that lack of access to affordable healthcare can have. My story begins my junior year of college. I washed a lot of pillow cases that year. For months, my ear bled onto my pillow nearly every night. I’d made the trip to the student health center where the student doctor called in all the others in the building to take a turn peering into my ear. It wasn’t the first or last time my ears were subjected to “can I grab a colleague/student/intern to see this” from the people I’d hoped would have answers. The health center sent me home with “let’s try” antibiotics and a list of full-fledged real Ear, Nose & Throat (ENT) doctors. My condition was beyond them. I could relate, the ENT doctor felt beyond me. I didn’t have health insurance. 

I did get to that ENT doctor and decided a little medical debt before I even hit 21 was the perfect way to start adulthood—okay, not so much as decided as I had no choice. I imagined walking out with a prescription after some poking, suctioning, and all the other terrors of ENT offices. (I had my first of many, many ear infections at just two days old, so I was a pro at ENT offices). Instead, I walked out with the name of a surgery the doctor said was absolutely necessary written on a piece of paper. As a full-time student and part-time waitress, the surgery costs were completely unaffordable. Time was not on my side as I’d already put off care because I was worried about finances. 

I was lucky to have generous and caring relatives that stepped up and covered the minimum amount the surgery center required to operate on me. For years, I’d get hounded by debt collectors for the rest. Perhaps most alarmingly, the cobbled together, delayed care had lifelong implications. An aggressive, antibiotic-resistant infection had eaten away the hearing bones in my left ear. The surgery was to remove the infection and frankly save my life by stopping it from spreading to "sorta" important organs like my nearby brain. The plastic hearing bones were like most things plastic these days—garbage. My doctor warned they’d probably do little to help me hear, and they did not. I was hard of hearing, and hearing aides were needed early in adulthood for me. 

A student facing a medical crisis today would be more likely to have health coverage—thanks to the Affordable Care Act (ACA). A provision of the ACA allows students to remain on their parents' health coverage until they turn 26. As a result, faster care, fewer attempts to patch together a plan to save money, and better outcomes would be expected. If not covered by their parents' insurance (perhaps their parents didn’t have insurance themselves, or because of estrangement), the student could likely qualify for the Healthy Indiana Plan (HIP)—or Medicaid expansion—also thanks to the ACA. Hoosiers 19 and older with incomes at 138 percent of the federal poverty level are eligible—for now. 

As someone who has experienced firsthand the negative repercussions that lack of access to affordable healthcare can have, I was ecstatic to learn young adults would be able to stay on their parents' health insurance for longer. When HIP was expanded to include millions of childless adults in the state, I breathed about 10 sighs of relief for what this meant for young people with medical issues. Unfortunately, those sighs have become daily gasps of horror this legislative session as the state is closing in on pulling health coverage for hundreds of thousands of Hoosiers, pushing us back to a time when your entire future could be jeopardized by bad (medical) luck.

Multiple Medicaid-related bills have been introduced this session, but Senate Bill 2 is especially worrisome because of its proposed work reporting requirements and increased administrative burden. Currently, no work reporting requirements are placed on HIP enrollees. In Arkansas, when work requirements were introduced, one in four recipients lost their health coverage (see 5 Key Facts about Medicaid Work Requirements). Many of those people were working or qualified for an exemption, but the red tape of the requirement was sticky and hard to escape. Indiana's SB2 introduces those work reporting requirements and that red tape, amongst several other proposed changes to Medicaid. 

Of all the items discussed around this bill, most alarming and striking to me on a personal level is the 36-month or three-year lifetime limit on someone utilizing HIP. (Note: While this language is not in the current version of the bill, it is possible this or other harmful language could be added back into the final version.) A young person could reach their lifetime limit around the age they are legally allowed to consume alcohol. Not to mention the crushing blow this would be to pregnant women. If they’d used their eligibility before becoming pregnant, they’d be facing a long 9 months of putting off care and cobbling together the best plan they could (as my plastic hearing bones show, this approach may not produce the best results). 

As of today, SB 2 has passed the Senate and is now in the House Ways & Means Committee. Below are three ways you can take action to push back against this harmful bill and fight to protect healthcare for hundreds of thousands of Hoosiers. Keep checking the MADVoters Bill Tracker to monitor the bill's progress and keep up with the latest calls to action.

CALLS TO ACTION

1. Contact members of the House Ways & Means Committee and ask them to vote "no" during committee votes.

2. Contact your state representative and ask that they vote "no" if the bill comes to a floor vote.

3. Join Hoosier Action for Protect Medicaid Day of Action at the Indiana Statehouse on April 1 from 11 AM to 2:30 PM.