State Legislators Give Updates On Medicare, Medicaid And Education

January 19, 2024 at 5:46 p.m.
State Reps. David Abbott (L) and Craig Snow (R) listen to Indiana Sen. Ryan Mishler on one of the television monitors Friday during the Kosciusko Chamber of Commerce’s Legislative Review Session. Photo by David Slone, Times-Union
State Reps. David Abbott (L) and Craig Snow (R) listen to Indiana Sen. Ryan Mishler on one of the television monitors Friday during the Kosciusko Chamber of Commerce’s Legislative Review Session. Photo by David Slone, Times-Union

By DAVID L. SLONE Managing Editor

With the Indiana Legislature’s session this year being a short one and non-fiscal, state Reps. David Abbott and Craig Snow and Sen. Ryan Mishler talked Friday about what they were doing down at the statehouse.
The discussion was part of the first Kosciusko Chamber of Commerce 3rd Legislative Review Session of the year, with a second tentatively scheduled for Feb. 9.
Medicare & Medicaid
While Snow said he was carrying three different bills this year, and co-authoring a couple others, Abbott said he had five but not all of them were going to get heard. One of the bills had to do with inappropriate materials in the classroom, while one had to deal with Medicare.
“This would provide some options for under 65. Disabled already gets it with disability insurance, but this would expand that to end-stage renal disease and also Lou Gehrig’s disease, and it basically would prevent discrimination against a person based on those conditions, whereas if they were over 65 their premiums would be fixed and they wouldn’t be discriminated. So it’s just trying to expand that coverage,” Abbott said.
Mishler said the purpose of the short session is to fix things from the previous year and his job in the short session is to strip the “fiscals” from bills because the budget typically isn’t opened on non-budget years. “Anything over $100,000 fiscal has to be recommitted on our side, and I typically strip them out,” he said.
He then brought up Medicaid.
“One thing that everybody’s heard about, and this is what I’m spending most of my time on, is the Medicaid forecast. It shows we’re going to be short by $984 million. So, we’ve got some ideas on that. We’ve had some reversion to put back, which cut it to $700 million. And, again, we’re not there, it’s just the forecast says we will get to that point of a negative $700 million, so we’re trying to make adjustments now so that doesn’t happen,” Mishler stated.
FSSA (Family and Social Services Administration) announced a couple days ago some of the internal changes they’re going to make, which will reduce the exposure a little bit, Mishler said. “There’s still a gap. Those things will have to be done by review of the budget committee, which happens to be Rep. (Jeff) Thompson and I, and legislative approval.”
He said they’ve started on narrowing the gap but have a long way to go.
“The one thing people aren’t talking about, because of the Medicaid piece, is our revenue forecast was off by $400 million as well, which means we’re expected to bring in $400 million less than anticipated when we did the budgets,” Mishler said. “So, that’s a $1.4 billion shortfall. I guess when you look at a $44 billion budget, you may say that’s not much, but I will tell you it is and it takes a lot of time to figure out how you’re going to get around that.”
A question from one of the virtual viewers asked, “We’ve heard the state is in great shape financially and is weighing its options on what to do with the surplus. How does the Medicaid shortfall impact those options and how will it impact the 2025 budget and beyond?”
Mishler responded, “The surplus is one-time money. So, when we do one-time projects, that comes out of that $2 billion-plus surplus we have. The Medicaid issue is what we call ongoing. So, that is on the structural balance. So, we have what we call a structural surplus, too, which I think is about $600 million. That is ongoing. So as you can see, that Medicaid alone would take up everything in that structured surplus because everything, like Medicaid, is ongoing, that’s the new bar. So wherever we end up on that $700 million shortfall that we’re at right now, that’s going to be added to the next budget for the starting point. So that’s when we have to bring that curve down because it will just continue to grow.”
He said they can’t use savings to pay off the Medicaid shortfall because Medicaid is ongoing.
Child Care
Snow is a co-sponsor of House Bill 1102, which appears to allow Class 1 child care providers to not apply for a license and just register, according to a question, “but not requiring a license to operate a Class 1 child care home implies that no background checks would be required. Is this accurate and, if so, what steps are being taken to keep these children safe?”
As the bill is written now, Snow said that is accurate.
“Yesterday we had a testimony on that bill in Family, Children, Human Affairs in the House. Rep. (Dave) Heine, who is the author, wasn’t there ... so I got to carry the bill that day,” Snow said. “Prior to that meeting, we had a lot of work we were doing with FSSA and some others, and we basically stripped the entire bill.”
He said all the language that was in Heine’s bill is gone and replaced with four amendments.
“So basically, no matter what you are - homecare, Class 1 or Class 2, you still have to go through the licensure process. You still have to have background checks. None of that changes.”
He said the impetus of the bill was to try to help the workforce have accessible and affordable child care. “Because across the state, there’s roughly 60% of the kids are having trouble being watched. So you’ve got that many families that are having trouble getting to work and those type of things.”
Snow said they’ve come up with a number of ideas to try to help. The first amendment dealt with adding one or two hours to each day, so instead of a child care provider being able to watch a child for four hours a day it’s up to six. Another idea was increasing the number of kids that can be watched by one or two.
“We’re going to allow for school corporations to have contracts with work places and contractually how their employees could have maybe a discount if they’re watched by the school,” Snow said.
The FSSA is still going to watch over that and background checks are still going to be required.
Currently, child care licenses are good for two years. That will be extended to three years to help daycares save money.
Third-Graders
The Indiana Reading Evaluation and Determination (IREAD-3) is a grade three reading assessment designed to measure foundational reading skills based on Indiana Academic Standards through third grade. If a third-grader doesn’t pass IREAD-3 the first time, they then have a second opportunity to pass in summer school. If they continue to fail, and don’t have an exemption, the third-grader may be held back.
A question to the state legislators asked for their thoughts on Senate Bill 1, saying, in part, “I believe that SB1 will increase the number of students that get retained. Most educational data shows that retention does not help a child learn, but it is a regressive punishment that further stigmatizes learning for that student.”
Mishler said SB1 just got recommitted to his committee and he just now is going through it.
“I will say this though: I just got my survey results back and I asked a question about retaining students who couldn’t read and it was like 80 or 90% in favor of what we were doing with SB1. It was an element of, what do we do with kids who can’t read? Do you retain them? Do you help them? We did a bill years ago that said if you can’t pass the IREAD test in third grade, you were retained. So I’m not sure where that missed the mark and now we’re doing it again. ... I’m not sure what happened because we’ve been down this path before,” Mishler said.
Abbott said he just had a meeting in Fort Wayne with over 20 school superintendents. One of their number one concerns was SB1 and retention. “Their big thing was doing the ILEARN test in third grade was, I guess, like assessing damage to a home after a flood happens, so pull that back to an earlier testing period so you don’t get to that point,” he said, adding that he wasn’t real familiar with the bill, but he liked the summer school idea.
Snow said he met with Warsaw Community Schools Superintendent Dr. David Hoffert and the school board and their biggest concern was how it would affect the child emotionally. Longtime former principals and school board members Randy Polston and Denny Duncan “offered up their suggestion and opinion that it would really devastate the child. So I think the idea was, do you look earlier - pre-K, kindergarten, first grade - to start? How do you stairstep this thing?” Snow said.
Mishler said the reason SB1 got recommitted to his committee was because the cost. “By retaining that child in third grade, it overall adds $50 million a year to the school planning formula.” Counting kindergarten, a child goes to school for 13 years, but if they’re retained a year, they’ll go to school for 14 years. “So, that $50 million hit wouldn’t be for about 10 years - we wouldn’t feel the effect for about 10 years - but that’s why it got recommitted to me, because there is a cost element to it and that’s what I dig into.”
Mishler also agreed with Snow and Abbott in asking if third grade was the answer. “If you can’t read by third grade, what can you really accomplish? So maybe we need to consider backing that off. So I agree with them 100% on looking at options on getting to the kids earlier than third grade,” he said.
Immigration
Pierceton Town Councilman Glenn Hall asked how the state of Indiana is being affected by the national immigration issues.
“How much time do you have?” Abbott asked, adding that he recently went down to the border at Eagle Pass after being invited by the Sheriff’s Association. He spent a couple days with border agents.
“It’s a mass invasion, and just to briefly break that down, about 50% are from Venezuela, about another 30% from Honduras. The rest - some of them are from Mexico, most of them from around the world. You name it, every country - good, bad, evil - are coming in that border. The cartels have a business going. And they’re pretty much paying them off is what I would say. ... They’re coming through and a lot of them are coming through Eagle Pass.”
He said a great number are refugees, fleeing Venezuela because of the government down there.
“The rich ones came through years ago, and now they’re coming through because Biden had said - this is what the Venezuelans told us - they said, ‘We’re down there, the borders are open, come one come all.’ And that’s what they tell you when they come through - ‘We were told we were invited, we get across the river, we’re welcome.’ And that’s why you’re seeing this flood of immigrants from those particular countries,” Abbott said.
He said the immigrants are here in northern Indiana.
Abbott said he started working on legislation in spring 2023 when he was approached by the sheriffs and an FBI special task who met with him and a state senator and they wanted to know what the legislators could do to help stop the influx in Indiana “because they had illegal cockfighting, horse racing, there was one in Cromwell, Indiana, that we actually broke up. Worked with FBI on this, special investigators, the state police investigators. We did a lot of research.”
In Cromwell, he said they had horse racing. They drugged quarter horses with a concoction of drugs and ran them down a 1/3-mile track and bet on the horses.
“These horses would die, their hearts explode. They ran 55 miles an hour with these drugs in them,” Abbott said.
Along with the illegal immigration, he said there was human trafficking going on, money laundering, drugs and more.
On stopping the illegal activity, he said it’s going to take “better police investigation, more effort and dollars to catch them. I think the border right now, they’re coming through unabated. We have to slow that flow down.”
He said not all of the immigrants were bad, but there’s at least 260,000 coming across the border every month - 200,000 through entry points and 60,000 through got-away points.
Abbott said the immigrants were not being vetted medically and they’re flooding the hospitals. Hospitals are losing millions of dollars on non-paying patients, including the illegal immigrants.
Opioid Settlement Money
During the Jan. 11 Kosciusko County Council meeting when the council approved about $300,000 from the county’s national opioid settlement funds to help Fellowship Missions purchase a downtown Warsaw for a recovery hub, Councilwoman Sue Ann Mitchell said the opioid money is not coming in like it was expected to. “Evidently, it’s not coming from the feds to the state and getting back to us, so there will be some research on why that’s not happening, I’m sure,” she said.
Asked Friday why the money wasn’t getting to the counties and cities like it was expected, Mishler said that was the first he heard of it.
“I would have to go back and ask the attorney general’s office. They’re the ones that are kind of leading the charge on that, so I would have to go back to them and ask them if there’s a hitch somehow, but no local community has reached out to me and said there’s a problem of receiving their settlement money,” he said.

With the Indiana Legislature’s session this year being a short one and non-fiscal, state Reps. David Abbott and Craig Snow and Sen. Ryan Mishler talked Friday about what they were doing down at the statehouse.
The discussion was part of the first Kosciusko Chamber of Commerce 3rd Legislative Review Session of the year, with a second tentatively scheduled for Feb. 9.
Medicare & Medicaid
While Snow said he was carrying three different bills this year, and co-authoring a couple others, Abbott said he had five but not all of them were going to get heard. One of the bills had to do with inappropriate materials in the classroom, while one had to deal with Medicare.
“This would provide some options for under 65. Disabled already gets it with disability insurance, but this would expand that to end-stage renal disease and also Lou Gehrig’s disease, and it basically would prevent discrimination against a person based on those conditions, whereas if they were over 65 their premiums would be fixed and they wouldn’t be discriminated. So it’s just trying to expand that coverage,” Abbott said.
Mishler said the purpose of the short session is to fix things from the previous year and his job in the short session is to strip the “fiscals” from bills because the budget typically isn’t opened on non-budget years. “Anything over $100,000 fiscal has to be recommitted on our side, and I typically strip them out,” he said.
He then brought up Medicaid.
“One thing that everybody’s heard about, and this is what I’m spending most of my time on, is the Medicaid forecast. It shows we’re going to be short by $984 million. So, we’ve got some ideas on that. We’ve had some reversion to put back, which cut it to $700 million. And, again, we’re not there, it’s just the forecast says we will get to that point of a negative $700 million, so we’re trying to make adjustments now so that doesn’t happen,” Mishler stated.
FSSA (Family and Social Services Administration) announced a couple days ago some of the internal changes they’re going to make, which will reduce the exposure a little bit, Mishler said. “There’s still a gap. Those things will have to be done by review of the budget committee, which happens to be Rep. (Jeff) Thompson and I, and legislative approval.”
He said they’ve started on narrowing the gap but have a long way to go.
“The one thing people aren’t talking about, because of the Medicaid piece, is our revenue forecast was off by $400 million as well, which means we’re expected to bring in $400 million less than anticipated when we did the budgets,” Mishler said. “So, that’s a $1.4 billion shortfall. I guess when you look at a $44 billion budget, you may say that’s not much, but I will tell you it is and it takes a lot of time to figure out how you’re going to get around that.”
A question from one of the virtual viewers asked, “We’ve heard the state is in great shape financially and is weighing its options on what to do with the surplus. How does the Medicaid shortfall impact those options and how will it impact the 2025 budget and beyond?”
Mishler responded, “The surplus is one-time money. So, when we do one-time projects, that comes out of that $2 billion-plus surplus we have. The Medicaid issue is what we call ongoing. So, that is on the structural balance. So, we have what we call a structural surplus, too, which I think is about $600 million. That is ongoing. So as you can see, that Medicaid alone would take up everything in that structured surplus because everything, like Medicaid, is ongoing, that’s the new bar. So wherever we end up on that $700 million shortfall that we’re at right now, that’s going to be added to the next budget for the starting point. So that’s when we have to bring that curve down because it will just continue to grow.”
He said they can’t use savings to pay off the Medicaid shortfall because Medicaid is ongoing.
Child Care
Snow is a co-sponsor of House Bill 1102, which appears to allow Class 1 child care providers to not apply for a license and just register, according to a question, “but not requiring a license to operate a Class 1 child care home implies that no background checks would be required. Is this accurate and, if so, what steps are being taken to keep these children safe?”
As the bill is written now, Snow said that is accurate.
“Yesterday we had a testimony on that bill in Family, Children, Human Affairs in the House. Rep. (Dave) Heine, who is the author, wasn’t there ... so I got to carry the bill that day,” Snow said. “Prior to that meeting, we had a lot of work we were doing with FSSA and some others, and we basically stripped the entire bill.”
He said all the language that was in Heine’s bill is gone and replaced with four amendments.
“So basically, no matter what you are - homecare, Class 1 or Class 2, you still have to go through the licensure process. You still have to have background checks. None of that changes.”
He said the impetus of the bill was to try to help the workforce have accessible and affordable child care. “Because across the state, there’s roughly 60% of the kids are having trouble being watched. So you’ve got that many families that are having trouble getting to work and those type of things.”
Snow said they’ve come up with a number of ideas to try to help. The first amendment dealt with adding one or two hours to each day, so instead of a child care provider being able to watch a child for four hours a day it’s up to six. Another idea was increasing the number of kids that can be watched by one or two.
“We’re going to allow for school corporations to have contracts with work places and contractually how their employees could have maybe a discount if they’re watched by the school,” Snow said.
The FSSA is still going to watch over that and background checks are still going to be required.
Currently, child care licenses are good for two years. That will be extended to three years to help daycares save money.
Third-Graders
The Indiana Reading Evaluation and Determination (IREAD-3) is a grade three reading assessment designed to measure foundational reading skills based on Indiana Academic Standards through third grade. If a third-grader doesn’t pass IREAD-3 the first time, they then have a second opportunity to pass in summer school. If they continue to fail, and don’t have an exemption, the third-grader may be held back.
A question to the state legislators asked for their thoughts on Senate Bill 1, saying, in part, “I believe that SB1 will increase the number of students that get retained. Most educational data shows that retention does not help a child learn, but it is a regressive punishment that further stigmatizes learning for that student.”
Mishler said SB1 just got recommitted to his committee and he just now is going through it.
“I will say this though: I just got my survey results back and I asked a question about retaining students who couldn’t read and it was like 80 or 90% in favor of what we were doing with SB1. It was an element of, what do we do with kids who can’t read? Do you retain them? Do you help them? We did a bill years ago that said if you can’t pass the IREAD test in third grade, you were retained. So I’m not sure where that missed the mark and now we’re doing it again. ... I’m not sure what happened because we’ve been down this path before,” Mishler said.
Abbott said he just had a meeting in Fort Wayne with over 20 school superintendents. One of their number one concerns was SB1 and retention. “Their big thing was doing the ILEARN test in third grade was, I guess, like assessing damage to a home after a flood happens, so pull that back to an earlier testing period so you don’t get to that point,” he said, adding that he wasn’t real familiar with the bill, but he liked the summer school idea.
Snow said he met with Warsaw Community Schools Superintendent Dr. David Hoffert and the school board and their biggest concern was how it would affect the child emotionally. Longtime former principals and school board members Randy Polston and Denny Duncan “offered up their suggestion and opinion that it would really devastate the child. So I think the idea was, do you look earlier - pre-K, kindergarten, first grade - to start? How do you stairstep this thing?” Snow said.
Mishler said the reason SB1 got recommitted to his committee was because the cost. “By retaining that child in third grade, it overall adds $50 million a year to the school planning formula.” Counting kindergarten, a child goes to school for 13 years, but if they’re retained a year, they’ll go to school for 14 years. “So, that $50 million hit wouldn’t be for about 10 years - we wouldn’t feel the effect for about 10 years - but that’s why it got recommitted to me, because there is a cost element to it and that’s what I dig into.”
Mishler also agreed with Snow and Abbott in asking if third grade was the answer. “If you can’t read by third grade, what can you really accomplish? So maybe we need to consider backing that off. So I agree with them 100% on looking at options on getting to the kids earlier than third grade,” he said.
Immigration
Pierceton Town Councilman Glenn Hall asked how the state of Indiana is being affected by the national immigration issues.
“How much time do you have?” Abbott asked, adding that he recently went down to the border at Eagle Pass after being invited by the Sheriff’s Association. He spent a couple days with border agents.
“It’s a mass invasion, and just to briefly break that down, about 50% are from Venezuela, about another 30% from Honduras. The rest - some of them are from Mexico, most of them from around the world. You name it, every country - good, bad, evil - are coming in that border. The cartels have a business going. And they’re pretty much paying them off is what I would say. ... They’re coming through and a lot of them are coming through Eagle Pass.”
He said a great number are refugees, fleeing Venezuela because of the government down there.
“The rich ones came through years ago, and now they’re coming through because Biden had said - this is what the Venezuelans told us - they said, ‘We’re down there, the borders are open, come one come all.’ And that’s what they tell you when they come through - ‘We were told we were invited, we get across the river, we’re welcome.’ And that’s why you’re seeing this flood of immigrants from those particular countries,” Abbott said.
He said the immigrants are here in northern Indiana.
Abbott said he started working on legislation in spring 2023 when he was approached by the sheriffs and an FBI special task who met with him and a state senator and they wanted to know what the legislators could do to help stop the influx in Indiana “because they had illegal cockfighting, horse racing, there was one in Cromwell, Indiana, that we actually broke up. Worked with FBI on this, special investigators, the state police investigators. We did a lot of research.”
In Cromwell, he said they had horse racing. They drugged quarter horses with a concoction of drugs and ran them down a 1/3-mile track and bet on the horses.
“These horses would die, their hearts explode. They ran 55 miles an hour with these drugs in them,” Abbott said.
Along with the illegal immigration, he said there was human trafficking going on, money laundering, drugs and more.
On stopping the illegal activity, he said it’s going to take “better police investigation, more effort and dollars to catch them. I think the border right now, they’re coming through unabated. We have to slow that flow down.”
He said not all of the immigrants were bad, but there’s at least 260,000 coming across the border every month - 200,000 through entry points and 60,000 through got-away points.
Abbott said the immigrants were not being vetted medically and they’re flooding the hospitals. Hospitals are losing millions of dollars on non-paying patients, including the illegal immigrants.
Opioid Settlement Money
During the Jan. 11 Kosciusko County Council meeting when the council approved about $300,000 from the county’s national opioid settlement funds to help Fellowship Missions purchase a downtown Warsaw for a recovery hub, Councilwoman Sue Ann Mitchell said the opioid money is not coming in like it was expected to. “Evidently, it’s not coming from the feds to the state and getting back to us, so there will be some research on why that’s not happening, I’m sure,” she said.
Asked Friday why the money wasn’t getting to the counties and cities like it was expected, Mishler said that was the first he heard of it.
“I would have to go back and ask the attorney general’s office. They’re the ones that are kind of leading the charge on that, so I would have to go back to them and ask them if there’s a hitch somehow, but no local community has reached out to me and said there’s a problem of receiving their settlement money,” he said.

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