Indiana’s legislative leaders sent a letter to the state’s health care providers and insurers a few months ago. In it, they told them to act now to reduce health care costs or lawmakers will take steps to do so next year.

IU Health, the largest health care system in the state, made its reply public. In its letter to legislative leaders, it defended its existing plans to address high health care costs. That includes moving a goal to reach national average prices to January 2025 (up from December 2025).

IU Health also laid some blame at the feet of lawmakers. It said Indiana’s poor citizen health is a contributing factor to high costs and notes, in its letter, that Indiana ranks 47 out of 50 in the country for public health spending.

But the head of the Insurance Institute of Indiana said its large hospitals that are to blame.

“Stop raking in record profits year after year … stop shifting funds around to mask the bottom line,” said Marty Wood, representing Hoosier insurance companies in a recent op-ed.

It’s likely that debate will continue into next session.

Contact reporter Brandon at bsmith@ipbs.org or follow him on Twitter at @brandonjsmith5.