More righty non-love for Mike

Yesterday, I posted about Indiana governor Pence's creation of a state-run news outlet.  He's already attempting to walk that back, given that it's being called "Pravda on the Prairie" and roundly castigated pretty much everywhere.

He's further eroding his righty bona fides today with the announcement of a program that is Medicaid in everything but name only (Healthy Indiana Plan 2.0).

There are two articles devoted to the boneheadedness of the idea at The Federalist.

John Daniel Davidson explains that there was a first version of HIP, conceived during the Mitch Daniels era.  It at least had a few free-market elements.  HIP 2.0, not so much:

It dragoons the entire non-disabled Medicaid population into the expansion scheme, not just those above the poverty line, and offers them a choice between a HIP Basic and a HIP Plus plan (some can also choose a plan that supplements employer coverage, a long-standing feature of traditional Medicaid), both of which feature a health savings account with a $2,500 deductible funded almost entirely by taxpayers.

The basic plan essentially requires nothing of enrollees. They get a health savings account and can either pay into it or not—the state will still cover the entire cost of the deductible and copayments will be limited to 5 percent of income, as they are for all Medicaid programs everywhere.

The HIP Plus plan includes vision and dental coverage, comprehensive prescription drug coverage, and requires no cost-sharing as long as enrollees keep up with monthly contributions to their account, which range from $3 to $25 a month. If an enrollee stops paying into the account, they won’t be kicked out of the program but simply get put on the basic plan. 

Davidson says that HIP 2.0 runs precisely counter to the basic conservative principle of fostering initiative and ambition:

 Consider than under Pence’s plan, a Hoosier earning $16,104 (or 138 percent of the federal poverty level, the income limit for Medicaid expansion under Obamacare) will pay a maximum of $322 a year for very generous HIP 2.0 coverage with no other out-of-pocket costs. If this person’s income increases at all, he loses his HIP account and will be forced to buy coverage on the Obamacare exchange, where his healthcare costs will skyrocket to nearly $2,800 a year in deductibles and copays for the benchmark silver plan.

Faced with such a choice, who would ever choose to earn more? In his statement, Pence said his goal is “to ensure that low-income Hoosiers have access to a health care plan that empowers them to take charge of their health and prepares them to move to private insurance as they improve their lives.” Yet the incentives built into his Medicaid scheme almost guarantee that poor Hoosiers will never opt to move to private insurance. They will instead become permanent dependents of Indiana’s expanding welfare system.

Joy Pullman expands on that point.  She describes the comfortably middle-class circumstances of her family, and the absurdity of qualifying for HIP 2.0:

We have a high-deductible health plan, so we pay essentially all of our medical bills in cash. And we have never had a problem affording that, despite having also paid cash for our three kids’ births, although affording health care does entail taking the kids to immunization clinics instead of pediatricians to cut costs and visiting quick-care clinics instead of emergency rooms when we have a malady that requires medical attention. But we don’t pay subsidized rates at the clinics. We pay the full cost. As my husband explained to the puzzled nurse once, “We can afford to pay.” If we can, so can lots of people Pence just told to stick their bills to taxpayers.

The clinic nurse was so confused as to why someone would turn down government “aid.” Apparently, my “conservative” governor feels the same way. Why pay for things yourself when you can use government force to compel other people to pay for you? Why encourage thrift and hard work in your citizenry when you can make yourself feel compassionate by giving away other people’s money? Never mind if it encourages poor people to stay poor. Never mind if you or your succeeding governor must raise taxes on working people like me, “poor” and otherwise, to pay for healthy people who choose not to work (or work very much). I mean, 284,000 of the 350,000 uninsured peoplewhom this plan will scoop into the arms of already overburdened taxpayers are able-bodied, childless adults. Apparently it’s enough to dub yourself “conservative” and let others pay the tab for believing it.

And she quite effectively makes the moral case against redistribution generally:

We should certainly not tell able-bodied people they deserve their neighbors’ hard-earned income because they earn less than 60 percent of their neighbors do. All this does is breed hopelessness and resentment among the dwindling number of “poor people” who, like me, do their darndest to pay their own way and instead of enjoying the fruits of their labor have to see it taxed away for people who will not similarly put their shoulders behind the wheel.

This is like telling the Little Red Hen that she has to make her cake from seed but everyone else gets to eat it anyway. If I were her, I’d either hide my cake or forget about making it at all. 

Once again, Mike has some big-time explaining to do.