The Indiana House advanced bills to lower health care costs, expand a ban on transgender athletes, and put in place new THC rules. (Niki Kelly/Indiana Capital Chronicle)
A House Republican priority measure to lower health care costs for Hoosiers, largely through “site of service” reforms, advanced Tuesday to the Senate — but it still needs work.
House Bill 1003 author Rep. Brad Barrett, R-Richmond, said its many “moving parts” aim to address problems within Indiana’s health care industry. The 73-page bill includes six key pillars: lowering costs; fighting waste, fraud and abuse; enhancing transparency; expanding access; promoting wellness and increasing competition.
Barrett raised concerns, for example, about the number of people still enrolled in the Healthy Indiana Plan, or HIP, following the end of the COVID-19 public health emergency.
As a remedy, his bill grants law enforcement powers to the Medicaid Fraud Control Unit within the Indiana Attorney General’s Office, and allows that staff to access law enforcement databases and collaborate with other agencies.
Barrett emphasized, though, that the bill is “not ready to cross the finish line yet.” But moving it along to the next stage in the legislative process “is the only way to fix it,” he said. A 66-32 House vote sent the bill to the Senate for further debate and amendments.
“We’re trying to lower costs. We’re trying to fight waste, fraud and abuse. We’re trying to enhance transparency for our patients so they know charges to get good faith estimates,” Barrett said on the House floor.
Democrats — although supportive of Barrett’s intentions — said the bill could have “unintended consequences” for patients and put “financial strain” on hospitals statewide.
“Not all outpatient settings, such as urgent care or substantial clinics, operate under the same cost structure as traditional physician offices,” said Rep. Victoria Garcia-Wilburn, D-Fishers. “Requiring parity in reimbursement rates may lead to reduced access to care, as providers may choose to limit the scope of services or opt out of contracts, especially in rural and underserved areas.”
Some Republicans had hesitations, too. Rep. Ethan Manning, R-Logansport, expressed concerns about “site of service” language that would prohibit health care systems from charging hospital-like prices for outpatient services.
“I think this bill will increase administrative and regulatory burdens for hospitals by billions upon billions of dollars, while at the same time decreasing their revenue by hundreds of millions, if not billions of dollars,” Manning said. “Because county hospitals and critical access hospitals are not exempt from any of these provisions, I don’t see any way around it. If this bill is not changed, moving forward … we will see lines of health care service eliminated in rural areas.”
“We should be supporting county hospitals and critical access hospitals in specific ways,” he continued, “not harming them with language like this.”
Manning also took particular issue with an “egregious” provision “that would effectively eliminate” the federal 340B drug pricing program.
Some hospitals and contractors have reportedly made millions off of the program, which is designed to help poor patients afford medication by giving participating health providers a steep discount.
“This would disproportionately harm small and rural hospitals. It’s a gift to Big Pharma,” Manning said. “I think we’d see more cost shifting, and we wouldn’t actually see any cost savings.”
Transgender sports bill heads to Senate
Legislation barring transgender women from playing on collegiate women’s sports teams moved out the House on Tuesday, prompting Democrats and a Republican to break with their parties.
House Bill 1041 would require all sports teams at Indiana’s public and private higher educational institutions to be either male, female or coeducational. Athletes assigned male at birth would be barred from participating in a “female, women’s, or girls’ team or sport.”
Colleges and universities would also have to establish grievance procedures for students or parents to file claims if a team violates the gender restrictions. Students who are “deprived of an athletic opportunity” or are “otherwise directly or indirectly injured” by their school’s violation of the ban would be able to file civil lawsuits.
Indiana bill to expand transgender athlete ban to college sports advances with bipartisan support
Author Rep. Michelle Davis, R-Whiteland, recalled playing sports as a girl and winning a full-ride scholarship to join Ball State University’s Division 1 basketball team. She dubbed her legislation as “commonsense” and said it’s “essential to protecting opportunities” for women athletes.
Democrats pushed back.
“Perhaps it’s hard to understand, difficult to empathize with a population you’ve ever engaged with. I can understand it might be jarring to reconcile with your faith, personal beliefs,” said Rep. Blake Johnson, D-Indianapolis. “I’ve been reminded by many for the last few days that this isn’t a politically advantageous issue to oppose. But today, we’re debating a bill that doesn’t solve a real problem.”
The National Collegiate Athletic Association’s (NCAA) leader told Congress in December that the organization has identified less than 10 transgender athletes.
After President Donald Trump signed an executive order earlier this month to ban transgender girls and women from participating in girls’ sports, the Indianapolis-based NCAA issued a new policy that no longer allows transgender women to compete in women’s college sports.
When Indiana lawmakers approved Davis’ 2022 bill to ban transgender girls from participating in K-12 sports, all House Democrats voted in opposition.
This time, however, Democrat Reps. Wendy Dant Chesser of Jeffersonville, Ed DeLaney of Indianapolis and Tonya Pfaff of Terre Haute voted with the Republican supermajority in a 71-25 tally, while Rep. Sheila Klinker of Lafayette reversed her supportive committee vote.
GOP Rep. Ed Clere of New Albany was the only member of his party to break ranks.
THC legal limit bill advances
An attempt to define when Hoosiers are too high to drive earned widespread, but not unanimous, support from the House.
Rep. Wendy McNamara said that Indiana’s “zero-tolerance” approach to marijuana means “that, if you’re in an accident and you have any amounts of THC in your system, you are automatically given a Class C misdemeanor.” Tetrahydrocannabinol, better known as THC, is the active ingredient in marijuana that makes users feel high.
McNamara’s House Bill 1119 identifies two specific oral fluid tests whose positive results can be used as “relevant evidence of intoxication.” It cautions that law enforcement officers can’t arrest people based solely on positive results. But the results could be admissible in court cases about driving under the influence along with other evidence of impairment.
Her proposal also lets toxicologists give testimony over video unless they’re absolutely needed in person, although she said that provision “needs some work.”
McNamara said she hopes to “cut down on wait time for technicians to come testify, keep them in the labs where they can actually do the toxicology, and keep our money from going out of state, frankly.”
The legislation moved on an 84-10 vote, with only fellow Republicans voting in opposition. It now heads to the Senate for consideration.
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