Wednesday, February 4, 2015

For Pence’s pride, feds swallow theirs

Posted By on Wed, Feb 4, 2015 at 8:00 AM

Gov. Mike Pence can rail against those despotic bureaucrats in Washington to his far-right constituency’s delight, but the much-maligned feds have managed to save the day for roughly 350,000 Hoosiers in need and perhaps for Pence himself.

Approval of his Healthy Indiana 2.0 plan ends a Kabuki dance of more than a year brought on by Pence’s insistence on holding his ground against Obamacare even if it meant holding his neediest subjects hostage.

At last, the valve opens for a massive influx of federal dollars that would have been welcomed with glee from the get-go if they financed fighter jets or highways instead of clinic visits and surgeries for people of a socioeconomic class that tends Democratic.

Sure, it’s expansion of Medicaid by another name; but with enough room for Pence to claim a states’ rights victory and blunt a backlash from the GOP reactionary wing, which is running out of purists on this fading issue anyway.

Clearly, the minions of the Obama administration who negotiated with Pence over all these tedious months had no interest in prolonging the agony – they aren’t running for president – and they sent signals all along that they’d find a way for him to save face if he would close some of the gap between Indiana’s program and Medicaid.

They got there, in part, by coaxing Pence into accepting a reduction in the sum he wanted participants to pay into health savings accounts, the “skin in the game” feature that goes along with Pence’s overall philosophy of demanding that low-income recipients of government help, unlike high-income beneficiaries of the inheritance tax repeal or private schools spending tax subsidies, show “responsibility.” Something like the “ennobling” benefit he ascribed to his food stamp cuts.

It will be a hardship for some – a payment of $3 to $25 per month into the account for persons with incomes above $11,500. There are some other strictures as well that folks on true Medicaid don’t have to endure. But hey, Pence Happens, and the feds knew good and well their choice was between half a loaf and none as long as the Republican caucuses were calling. And every month some Hoosiers died for lack of affordable medical care. Nobody knows how many. If Pence cared, he didn’t say.

And remember, Pence has asked the U.S. Supreme Court to cut off federal health insurance subsidies for more than 100,000 Hoosiers under another section of the Affordable Care Act, just because the state opposes the ACA. Take that, Obama!

To hear Pence now, crowing about his triumph and extolling his comparatively puny health program as a model for the nation, can’t be pleasant for the professionals on the other side of the table. But if you know a lot of government employees, you’ve heard a lot of accounts of hard work for which politicians take credit. Without being privy to this marathon dance, I am surmising that some salary-earners with no agenda aside from giving Indiana money for health care did their jobs, while a governor beset with hubris and fearful of the Tea Party did his.

It’s a shame it had to work this way, with real victims twisting in the wind. But a bureaucrat who manages to sell Obamacare to a guy who’s shouting “Repeal Obamacare” has earned his/her paycheck for sure.

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Dan Carpenter

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