Porter: We can disagree on policy while showing respect to Medicaid enrollees
Republicans have enacted Medicaid changes with quarterly eligibility checks, work requirements, new waivers and long waitlists. That’s a lot of uncertainty for our 2 million Hoosiers enrollees, half of whom are children. And I want to remind us all of that fact.
We’re talking about children. We’re talking about our seniors. We’re talking about our medically complex. We’re talking about half of the births in Indiana. We can disagree on the logistics while still talking about enrollees with kindness and respect. Medicaid was never “boring” for the Hoosiers who rely on it.
Medicaid rhetoric has always been somewhat nasty. Phrases like “welfare queen” have been thrown around for decades. But now it’s bleeding from social media into official meetings. The recent quarterly financial report from the Family and Social Services Administration (FSSA) is excellent evidence.
One slide featured a massive steamship, called the "S.S. FSSA," with Secretary Mitch Roob portrayed as its admiral. Another slide characterized one-time federal funding for Medicaid as “the last buffalo hunt.” A third slide shows a photo of conservative economist Milton Friedman with the phrase “very few of our programs have any quality.”
The final slide pitted K-12 education funding against Medicaid. A dejected child appeared with the caption: Why? Every dollar we send to a hospital is a dollar we don’t send to a school. Every dollar we give to a doctor is a dollar we don’t give to a teacher. This misguided cliché isn’t just harmful, it's inaccurate. Medicaid spending isn't a direct loss of funding for K-12 education. Upcoming property tax changes will be far more financially devastating to our schools than state-funded health care.
Yes, Medicaid is costing the state more each year. Yes, it’s something the state should discuss. Yes, we can improve the quality of services. But we should have these discussions with dignity. The use of demoralizing rhetoric isn’t just insulting; it buries the facts.
The S.S. FSSA navigates “the journey ahead,” but the slide leaves out critical facts. Indiana spends $8,813 per enrollee, close to the national average and far below other states. North Dakota spends close to $13,001 per enrollee. Milton Friedman attacks the quality of services but doesn't provide solutions. There are no action items included, like the Accountable Care Organizations model. We’re going on a buffalo hunt and letting other predators join. Middlemen insurance companies will have a hand in pricing, delays and denials.
Medicaid is not a perfect program. It has its problems that need to be solved. We can have the discussion with respect, without slides that attempt to joke but fall flat. We shouldn’t vilify enrolled or use false constructs. This is a life-saving program for Hoosiers of all ages. These aren’t just numbers on a page; these are Hoosiers we took an oath to serve.