Health leaders flag Medicaid, public health as major policy concerns ahead of session

Indiana lawmakers say Medicaid will be a major health policy concern heading into the legislative session. The leader of the House health committee said the theme for the Medicaid program this year is “change.”

Medicaid costs have been a major focus since officials announced the $1 billion forecasting error in 2023. The state put a series of cost-containment strategies in place that generated $348 million in savings.

However, the state did underestimate how many people would remain in the Medicaid program after the end of the COVID-19 public health emergency, which meant the net savings to the state budget was about $85 million.

Rep. Brad Barrett (R-Richmond), chair of the House Public Health Committee, said with new gubernatorial and presidential administrations set to begin, there are a lot of changes happening on federal and state levels.

“We have an opportunity to have the institutional knowledge when everything else is changing around us,” Barrett said. “I look at that as a great opportunity for the legislature in Indiana this year.”

Barrett said conversations around Medicaid in the Statehouse tend to go through cycles.

“It's just the nature of this game,” Barrett said. “It's a tug of war between, you know, often two conflicting ideas. In health care, particularly, we have the policy versus the fiscal. We also every year deal with the federal issues versus state.”

Rep. Robin Shackleford (D-Indianapolis), the ranking minority member in the committee, said the focus should be protecting services.

“I know we have less revenues coming in and Medicaid rate increasingly keeps going up, but at the end of the day, I'm going to define success in what our Medicaid program looks like,” Shackleford said. “And how we're going to get a handle on the spending is we have to invest more in prevention.”

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Senate Health and Provider Services Committee Chair Ed Charbonneau (R-Valparaiso) also said lawmakers have a responsibility to remember who is impacted by fiscal changes.

“Every dollar that we talk about, there's a face behind it,” Charbonneau said. “We should never lose sight of the fact that it's not numbers, it's people that we're dealing with.”

Lawmakers will also revisit Indiana’s historic public health funding program as they develop a new state budget during this year’s legislative session.

Indiana’s public health system was overhauled as a part of legislation signed into law in 2023. The current state budget divided $225 million to all the counties that chose to participate.

Charbonneau said the program plays an important role in the prevention of illness, which can save the state more money in the long run.

“We need to make sure as we go through the session this year, that, number one, that 225 million is protected but somehow maybe grow the program a little bit,” Charbonneau said.

Health leaders also say they expect a variety of other topics to appear during the budget year session, including regulations on pharmacy benefits managers and prior authorization, as well as gathering information about Indiana hospitals’ participation in the federal 340B drug program. Some lawmakers also hinted at reopening conversations about a cigarette tax.

The legislative session begins on Jan. 8.
 

Abigail is our health reporter. Contact them at aruhman@wboi.org.