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The national Republican Party hates the Affordable Care Act so much that it is trying to end the popular requirement that health insurance cover pre-existing illnesses. This is not a “welfare” program but a benefit for anyone who is insured, including all those who get coverage through their work.
The members of the supermajority in the Indiana General Assembly could act to protect us if their friends in Washington lash out to end this protection. That would require them to deviate from the current Republican orthodoxy, which prizes posturing over policy, bitterness over compassion.
The primary duty of government is the protection of our citizens. Under our federal system, that responsibility is often shared. Just look at how we allocate national defense and disaster relief between federal and state governments. Indiana has done well by its citizens and the nation in those key areas of shared responsibility.
But the Republican Party in Washington wants to end the sharing of responsibility to regulate health insurance. These ideologues would dump the issue back to the states and hope to reduce protections that benefit all of us. The General Assembly could fill the regulatory void and protect the health and financial security of Hoosiers or can just let us all down.
While it is not widely discussed, the fact is that the General Assembly in Indiana, like all of our states, has broad authority to regulate the insurance industry, including the health insurance industry. Until the passage of the Affordable Care Act, our regulation was a very light touch. The Indiana General Assembly did not require coverage of pre-existing conditions, young adult children or pregnancy, or provide lifetime caps on out-of-pocket expenses.
Perhaps we feared getting out ahead of other states and affecting our own substantial health insurance industry. The ACA not only provided these key protections but made these coverages a national mandate. And Hoosiers have benefited.
Critically, these benefits extend to all who have health insurance, not just those insured on the exchanges or by Medicaid. The question is whether the Republicans who now have a supermajority in the General Assembly will favor the politics of resentment over providing protection for Hoosiers.
The ACA was a departure from the historical allocation of insurance regulation to the states. That departure was one of the philosophical bases for the Republican objection to the whole idea of establishing nationwide standards for health policies. Republican leaders claimed it just wasn’t Washington’s job. At the same time, they were indifferent to requiring coverage for pre-existing conditions, no matter who did the regulating. Well, we have tried the idea out and it works. People can be assured of coverage. They can change jobs without risking their coverage. Insurers can work on controlling costs rather than rejecting people.
All these gains are at risk. But the risk can be avoided.
There are only two ways to ensure that Hoosiers will continue to get protection when they have pre-existing conditions such as diabetes, cancer or heart illness. One is for a change of heart by the embittered Republican Party. The other is for our voters to put an end to the supermajority in Indianapolis and replace the ideologues who control most of our congressional seats.
I know which option makes me more confident that our coverage will remain.•
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DeLaney, an Indianapolis attorney, is a Democrat representing the 86th District in the Indiana House of Representatives.
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