Obama cares — does Indiana?

The Affordable Care Act is often perceived as either a socialist plot to undermine the integrity of “Real America,” or the saving grace for America’s health care system.  

Obamacare is neither of these things.

The legislation is clearly a step in the right direction — an attempt to expand insurance coverage, to crack down on unfair practices, to encourage preventative care — but it’s inconsistent implementation across the country reveals some serious flaws.

It seems that the ACA’s efficacy is dependent on each state’s confidence in the legislation. 

While California has managed to establish an exchange that is projected to open with costs well below those feared upon the passage of Obamacare, it also has tried significantly harder than other states to bargain down costs and sign people up.

Compare its efforts to states such as ours, where representatives are actively trying to prevent the law’s application. Congressman Luke Messer, R-Ind, is proposing a bill that would “protect” schools from complying with the mandate.

“It is unconscionable that the Federal government is taxing schools to help pay for the
health care law,” he said.

I think it’s unconscionable that Indiana’s government cut $300 million from the K-12 education budget in 2009 and, despite recent surpluses, has failed to replace those funds.

The congressman conveniently forgets how little Indiana seems to care about education funding in order to vilify a law that attempts to ensure the people who work in our schools have access to affordable medical care.

Even without a law that provides “protection” from lunch ladies having doctors and being healthy, Indiana institutions have already found a way to circumvent the intentions of the ACA. IU announced in May that hourly employees would be limited to 29 hours a week — few enough hours that our school no longer has to insure them.

Cleverly, IU has found a way to leave workers both uninsured and underemployed.
Of course, part of the incentive for IU’s policy change is wrapped up in the fact state funding for our supposed state school has dwindled to about 16 percent, and will probably continue to decrease.

All of these factors — both state and institutional evasion of ACA intentions — reveal the initiative does not go far enough.

One of the fundamental problems with the U.S. health care system is that we are dependent on our employers as providers. Most of these employers are in turn dependent on a bottom line. Health care costs in the U.S. are inordinately (and arbitrarily) expensive. The incentive for taking the short term hit and insuring all employees is not immediately apparent for most, and so those who were vulnerable before the ACA could be even more vulnerable after.

In light of recent government overreach and invasion of privacy, it is a little strange to be advocating more government. But health care is a place where, unlike my phone records or Facebook profile, expanded government involvement and regulation could be a good thing.

A government option outside of Medicare and Medicaid — one that existed in conjunction with private options — could be a great opportunity to keep workers at full employment and full health. 

We know our health care system is a work in progress.

Let’s make a little more progress.

­— casefarr@indiana.edu