Supporting the Full Expansion of Medicaid in Indiana through the Affordable Care Act

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RESOLUTION NO. \. 32—Y — t SUPPORTING THE FULL EXPANSION OF MEDICAID IN INDIANA THROUGH THE AFFORDABLE CARE ACT WHEREAS, Indiana ranks poorly in measures of health. We are 41st out of all 50 States in overall health, with our position falling four spots since 2011.1 We are a disgraceful 47th in infant mortality; WHEREAS, Within Indiana, St. Joseph ranks 43rd out of all Indiana counties in overall health.% Also, St. Joseph County's obesity and smoking rates are higher than goal rates set by the Indiana State Health Improvement Plan;+ WHEREAS, Under the federal Patient Protection and Affordable Care Act (ACA), States have a choice to allow access to health insurance coverage through the Medicaid program for residents living under 138% of the Federal Poverty Level (currently $27,310 per year for a family of three). Expanded Medicaid would cover screenings, doctor visits, prescriptions, dental and vision, mental health, and hospitalizations; WHEREAS, Because Indiana ranks poorly in measures of overall health, when considered in relationship to most other States, Indiana stands to gain more relative to other States in improved health outcomes by expanding Medicaid; WHEREAS, There are 801,000 uninsured Hoosiers. Approximately 182,000 of these uninsured Hoosiers do not qualify for traditional Medicaid and cam too little to be eligible for subsidies to purchase insurance in the Indiana Health Insurance Exchange? These are primarily working adults ages 19 -64 who work in retail, education, temporary agencies, home health, childcare, and other jobs with lower wages and minimal benefits. Many are working more than one job. Without access to some version of Medicaid, these Hoosier neighbors will continue to have no option for health insurance; WHEREAS, An estimated 13,700 uninsured veterans in Indiana could qualify for the Medicaid expansion; - WHEREAS, The Medicaid expansion is 100% federally funded for the first three years (2014- 2016) and at least 90% federally funded thereafter. The cost to Indiana taxpayers has been estimated to be between $50 and $150 million per yearr (this compares to Indiana's current annual cost of $1.9 billion for traditional Medicaid);" WHEREAS, The State share of the cost of Medicaid expansion can be completely covered by other savings. The State currently collects cigarette taxes designated for the Healthy Indiana Plan (HIP). In 2013, these taxes amounted to $122.9 million; furthermore, the balance of the HIP trnst fund is currently $320.2 million.9 These sources of HIP revenue alone would cover the State's share of Medicaid expansion. Any costs of expansion must be considered alongside expansion's savings, such as savings to off -site prisoner health expenses and the cost of the Indiana Comprehensive Health Insurance Association (the "high risk pool," which is being phased out);10 WHEREAS, Costs are also outpaced by potential revenue. The federal share for Medicaid expansion would mean $10.5 billion in revenue coming into Indiana through 2020 at a rate of $1.5 billion a year. Spending by the federal government on Medicaid expansion would generate an estimated $2.4 to $3.4 billion in new economic activity in Indiana from 2014 to 2020, which could finance over 30,000 jobs through 2020.11 Medicaid expansion would increase State and local tax revenue by $108 million a year; 12