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Posts Tagged ‘Mike Pence’
October 7th, 2014 at 6:06 pm
Pence-HHS Negotiations over How to Expand Medicaid Stall

A months-long negotiation over whether and how Indiana might expand Medicaid under ObamaCare may be coming to an impasse.

On Monday, Indiana Republican Governor Mike Pence emerged from a meeting with federal Health and Human Services Secretary Sylvia Burwell Mathews without any positive news.

“We had a substantive discussion, but we are not there yet,” Pence said in a statement quoted by the Indianapolis Star.

At issue is whether Indiana will be able to use ObamaCare’s Medicaid expansion dollars in a way that moves the program in a more market-friendly direction. As I’ve written before, conservatives can support reforms to entitlement programs so long as they move in that direction.

With HHS refusing to let Indiana require modest co-pays under its expanded Medicaid plain, the next move is up to Pence. He could weaken his proposal, but doing so would sacrifice any pretense his plan has for being fiscally conservative. On the other hand, he could stand firm on principle and absorb the potentially damaging criticism that he’s leaving almost $1 billion in federal Medicaid payments on the table – all of which is new taxpayer-financed spending.

Pence is thought to be a dark horse GOP candidate for president in 2016. His decision on this policy issue will go a long way towards determining how viable such a campaign would be.

April 5th, 2013 at 3:52 pm
HHS Refuses State Requests for Medicaid Expansion Flexibility

States looking for flexibility under ObamaCare in how to structure and pay for expanding Medicaid can take a hike, according to an analysis by the Heritage Foundation.

States like Arkansas and Indiana have requested waivers from the health reform law’s expansion formula that creates millions of new enrollees at an eventual cost of billions of dollars to states.

The hope was to use existing state-based models like Indiana’s successful health savings account for low-income Hoosiers to increase Medicaid enrollment while retaining cost certainty for state budget writers.

But those hopes were dashed after the federal Department of Health and Human Services released a frequently asked questions (FAQ) sheet that flatly denied any request to deviate from ObamaCare’s one-size-fits-all, open-ended spending commitment for Medicaid.

With this announcement, the Obama administration has definitively articulated its idea of bipartisan reform.  Republican governors who capitulate and get in line are welcomed with open arms.  Those like Indiana’s Mike Pence can take their policy entrepreneurship somewhere else.

April 1st, 2013 at 2:49 pm
Indiana’s Pence Makes Progress with Innovative Medicaid Expansion

The Indianapolis Star reports that Indiana Republican Governor Mike Pence, a possible 2016 presidential candidate, cleared an important hurdle today when the state’s House Public Health Committee approved a bill to expand Medicaid eligibility without relying on ObamaCare’s open-ended spending incentives.

Pence’s plan would increase Indiana’s Medicaid enrollment by an estimated 400,000, but within the state’s Healthy Indiana initiative begun in 2007.  As a health savings account, Healthy Indiana allots a certain amount of money to qualifying Hoosiers who then shop for doctors and treatment options within their budget.  In effect, it transfers the decision making process for health care away from government bureaucrats to private citizens.  By capping the amount, Healthy Indiana also gives state budget writers more certainty about the cost of Medicaid expansion in future years.

Contrast this with the unlimited spending commitment envisioned by the Medicaid expansion system under ObamaCare, and conservatives will see why Pence’s proposal should be watched closely.  Under ObamaCare, states would pay no cost for expanding their eligibility pool up to 138 percent of the federal poverty line.  But starting in 2017, those that expanded enrollment would pay for 10 percent of the increase.  Though seemingly a small percentage, the costs will run into the billions, with even more likely if the federal government decides to reduce its 90 percent subsidy, as President Barack Obama has already hinted at doing.

The future of health insurance reform looks like it will include some mix of government-regulated exchanges, subsidies, and cost controls.  The question dividing conservatives like Mike Pence and Paul Ryan on one hand from liberals like Obama on the other, is who gets to make the lion’s share of the decisions on how health insurance dollars are spent.  Conservatives value individual choice, while liberals favor centrally planned mandates.

Ironically, if the President wants ObamaCare to be fiscally sustainable, he’ll have to accept that the only way to do it is allowing conservatives like Pence and Ryan to inject into it as much personal freedom as possible.

February 8th, 2013 at 8:15 pm
Indiana’s Pence Wants Sensible Reform to Medicaid Expansion

Like Ohio’s John Kasich and four other Republican governors, Indiana’s Mike Pence seriously considered expanding Medicaid eligibility under ObamaCare.  But unlike Kasich & Company, Pence ultimately decided against it when HHS refused to grant him one sensible reform.

Established under Mitch Daniels, Pence’s predecessor, the Healthy Indiana program allows uninsured adults aged 19-64 to use a state-based health savings account to pay for medical expenses, such as doctor’s visits, hospital services, diagnostic tests, and prescription drugs.  Incentives apply to reward cost-effective spending, but it’s critical to point out that the spending decisions within the account are determined by the policyholder, not the state.

In order to go along with expansion under ObamaCare that increases the eligibility pool for Medicaid, Pence asked permission to use Healthy Indiana accounts to help keep costs down.  The request is imminently reasonable.  If the purpose of Medicaid expansion is to cover uninsured people, why not let Indiana migrate a state-based program with a 94% satisfaction rating?

Predictably, Kathleen Sebelius’ Department of Health and Human Services said no, preferring to retain federal control over coverage and spending.  Without a program like Healthy Indiana in place, costs are likely to spiral upward since Medicaid beneficiaries are not tethered to the consequences of their spending decisions.

So, Pence said no to the Medicaid expansion.  But I think it’s crucial to understand that his response was not a kneejerk reaction against helping the uninsured get normal access to healthcare.  Instead, he proposed a sensible reform that would have accomplished the same goal as Medicaid expansion, but with more cost certainty for the state budget, and thus less tax receipts from taxpayers.

I’ve speculated before that Pence might be the GOP’s best bet in the 2016 presidential race.  A moment like this, even when it doesn’t result in a “win” politically speaking, helps confirm that suspicion because it’s based on sound principles.

October 25th, 2011 at 3:28 pm
Like It or Not, This is Your Presidential Field
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I’m in agreement with Quin’s sentiment, expressed below, that the Republican presidential field could have benefited from a few more entrants, especially if it was accompanied by getting rid of some of the dead weight currently in the field (at this point, I’d be happy for the debates to be four-man affairs with Romney, Perry, Gingrich, and Cain). For some perspective, imagine the lineup on stage for a debate between those who passed on the race: John Thune, Sarah Palin, Paul Ryan, Mike Pence, Mitch Daniels, Bobby Jindal, Haley Barbour, Jeb Bush, and Chris Christie. That’s a group that is depressingly more presidential than our current crop.

I don’t share Quin’s optimism, however that the field is going to change. Mike Pence has pretty safe odds to become the next Governor of Indiana, a prospect that’s not worth sacrificing for a long shot presidential bid out of the House of Representatives. Bobby Jindal would have engaged in something just short of electoral fraud if he jumped in the race only days after winning a second term as governor (the Iowa Caucuses will actually be held before he is even sworn in for his next term).

One factor, however, is nearly dispositive: timing. Next Monday is the filing deadline for the Florida Primary. Tuesday is the deadline in South Carolina. If we’re going to see anyone else in the field, it’s going to have to happen in the next few days. Putting together a campaign on that timeframe — particularly when most of the big donors and premium staffers have already been snatched up — is next to impossible, which means this field is almost certainly set. Like it or not, the next time you the see the candidates take the stage at a GOP debate, you’ll be looking at the future Republican presidential nominee.

April 9th, 2011 at 12:09 pm
2012 the Year of the Senate?

The (British) Guardian promotes an interesting theory about the 2012 electoral cycle: maybe Republicans should focus more on winning the Senate than the presidency.  Here’s the rationale:

And here’s more potential bad news: in 2014, another 20 Senate Democrats are up for re-election, compared to just 14 Republicans. That means over two successive election cycles, 43 Democrats – 80% of those currently in office – must defend their Senate seats, compared to just 24 Republicans. Could the GOP end up with a 60-vote super-majority of its own, just two years before laying siege to the White House in a post Obama contest?

The strategy doesn’t explicitly cede the presidential campaign to President Barack Obama, but it does acknowledge that the current crop of likely GOP presidential contenders don’t include the exciting names conservatives want (e.g. Mike Pence, Chris Christie, John Thune).

Consequently, don’t be surprised if conservative activists and donors spend their time and money electing more senators like Rand Paul and Marco Rubio instead of backing whichever compromise candidate emerges with the presidential nomination.

March 17th, 2011 at 7:41 pm
House GOP Leaders Losing on Two Fronts

There’s a confrontation brewing between fiscal conservatives in the House GOP caucus and their leadership over how best to handle the budget crisis.  House leadership wants to keep negotiating while passing short-term spending bills to avoid a shutdown.  Fiscal conservatives like Rep. Mike Pence (R-IN) are voting No and getting killed for it.

Pence is fighting back.

“I have no doubt that Speaker John Boehner and Republican Leader Eric Cantor and the rest of our leadership will privately, and if needs be, publicly denounce any effort to essentially bad mouth the intentions of Republicans that are simply fighting for fiscal responsibility,” the former GOP conference chair said Thursday morning on “The Hugh Hewitt Show.”

It’s funny to hear that the House leadership is fuming at fiscal conservatives for voting their principles when those same leaders say that the latest budget extension is the last one.  With House leadership moving towards the fiscal conservatives’ position, maybe leadership is just ticked that they’re losing negotiations with both Democrats and Republicans.

January 27th, 2010 at 1:42 am
Millions for Democratic Losses, But Not a Pence for Republican Victories
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Bad news for political junkies — what could have been the title fight of the 2010 midterm elections in the U.S. Senate has been called off.

RedState reported this morning that conservative Indiana Congressman Mike Pence has decided against challenging moderate Democratic Senator Evan Bayh for his seat this year.

No doubt that it would have been an uphill fight. Bayh comes from an extremely popular political family in the Hoosier State, and his own career as a centrist governor-cum-senator has endeared him to his electorate. He’s also towards the bottom of the list of Democrats in the Senate who are threatening to conservative principles (and one of the few who sees the folly in the liberal thrust of the current Democratic leadership).

Yet the fact of the matter was that Pence was outpolling Bayh (albeit narrowly) without so much as announcing. Pence’s victory could have gone a long way towards driving a total electoral scramble in November.

Hopefully, the talented, able, articulate Pence goes back to the grindstone in the House. If he’s passing up the Senate race to take a crack at the White House (as RedState suggests he may be), he’s trading the improbable for the virtually impossible. Only one sitting U.S. Representative has ever been elected to the presidency — and Washington isn’t exactly brimming with people looking to replicate James Garfield’s legacy.