A bill targeting nonprofit hospitals signed into law.

The governor signs a bill banning DEI.

Plus reviving an A to F grading system for schools and more.

From the television studios at WFYI, it's Indiana Week in Review for the week ending May 9th, 2025.

Indiana Week in Review is produced by WFYI in association with Indiana Public Broadcasting stations.

Additional support is provided by the Indy Chamber Working to unite business and community to maintain a strong economy and quality of life.

This week, a bill signed into law will ensure Indiana's largest nonprofit hospital systems eventually face limits on how much they can charge for care.

Indiana Public Broadcasting's Abigail Ruhman reports those hospital systems would have to meet certain requirements by 2029, or forfeit their nonprofit status.

The bill requires the state to conduct a study to determine average hospital prices.

Indiana's Big five nonprofit hospital systems then have to set prices equal to or less than the statewide average.

Lawmakers say hospitals can choose to lower prices or transition to a for profit model.

Senator Tyler Johnson says the bill doesn't explain what happens when a system fails to adhere to the price limits and loses its nonprofit status.

We can say we are never going to get there because they'll either become for profit or go underneath it.

But that's not the bill we're passing.

What happens when you violate them?

Johnson and other opponents say nonprofit hospitals are licensed under a nonprofit corporation.

They say a hospital license is tied to their nonprofit status, so losing the status means losing the license.

Can this bill impact health care costs?

It's the first question for our Indiana Week and review panel.

Democrat Elise Schrock.

Republican Mike O'Brien.

Oseye Boyd, editor in chief of Mirror Indy.

And Niki Kelly, editor in chief of the Indiana Capitol Chronicle.

I'm Indiana Public Broadcasting Statehouse bureau chief Brandon Smith.

Obviously, this bill doesn't really take effect for a long time, or at least the requirements of it.

But can it eventually move the needle on health care costs?

I mean, I think it's a small step forward, but I think with most of the health care bills that we saw this session, it's a small step forward.

And, we have a supermajority that could be doing a lot more.

We've studied this for a couple of years.

we saw some actually at the beginning of session, I think we saw some pretty aggressive, things come out, but then by the end of session, things had been watered down.

I also think there is still some risk with this.

Right.

So the one of the points brought up.

So the risk is if these hospitals lose their nonprofit status, what happens?

Are we going to risk closing ERS and jobs that are already.

at risk of closing or.

Or have already closed across our state?

I do think that there is, again, there have been proposals from Democrats every single year to focus on preventative care.

That's also something that we should be paying a lot of attention to every year.

And every year we see those bills get shut down by Republicans.

The theme of these bills got watered down by the end of session, has been a common one with these health care bills the last few sessions.

Were you surprised by how far scaled back so many of the bills were this year, when there seemed to be much more focus on, okay, we really need to start taking bigger steps.

Well, I think they get into it.

You know, Tyler Johnson did a great job over the interim of trying to address prior authorization reform.

And he had stakeholder meetings and like really tried to like thoroughly go through the industry and say, okay, where can we land on, on some of these things and bring me your own ideas?

So, I mean, it's not like they just spring these, you know, feelings on that example.

then just spring these bills.

Some do.

I mean, like, look, they're trying their date, the legislature for last, like, ten years.

I've been doing this for 25 years.

And I started at the State Medical Association.

A lot of these conversations are the same as they were in 2001. because but it's complicated.

So even if even if you and they're looking for the lever, if they're looking for like, how do we how do we incentivize and force better behavior, lower costs, more transparency.

and it's not easy to find because even even if, you know, we get to 20, 29 and, you know, you're a nonprofit hospital and you, you exceed this reimbursement, rate, that's the trigger.

You lose your state nonprofit status, which really only means you pay you pay property taxes, you don't lose your federal nonprofit status, which is kind of the ball game.

you know, so, like, they that's just like what they run into.

And part of the problem is a lot of this is governed by federal law.

A lot of these, you know, most people listening to this are not insured by it, an insurance policy that is governed by state law.

It's it's preempted by federal law.

Medicare's the largest purchaser of Medicare is the one that moves the needle really on on price because they're the largest purchaser in the world of health care.

you know, so they they're they're doing their best to try to address this cost problem without a lot of levers to do it.

So this is a is always a challenge.

With some of this stuff particularly I think about this nonprofit hospitals bill.

The this wasn't a Republican versus Democrat issue at all.

You had folks in both parties on both sides of this issue.

And for the Republicans, a lot of it was a a genuine philosophical problem with the government telling an industry, you can only charge this much for this thing, but are we going to start to see as health care costs don't come, they certainly don't go down.

And the curve seems to just keep going up.

Are we going to start to see even Republicans who had that philosophical view go, well, maybe it is time for the government to to start to be a little more.

Almost punishing regulation, more regulation.

I thought about that, point that you just made, that most industries, the government tries to stay out of dictating the prices.

But when you see astronomical costs with health care, when people are afraid to go to the hospital, afraid to go to the doctor because of the cost, when you have, Tylenol, that it's like a dollar.

But then when you get your hospital bill is somehow it's like $5,000.

something has to be done.

But exactly what and where and when the government steps in.

It's it's complicated to your point.

It's very complicated.

But we've seen these prices go up over and over and over, year after year after year.

And people many people don't even know the hospitals are nonprofit.

So that I don't think you walk in and.

I don't even think that even factors into people's minds that many people don't know, that many hospitals do have, a way that they can you can get help with your bill, that it's still like something that people don't actually know exists.

So I don't I don't think people really care about nonprofit or profit.

They just care about can I afford to pay this bill when the bill comes?

And I shouldn't pretend like lawmakers did nothing in this session.

They did take step.

I mean, the nonprofit bill is an example.

Even if it got pushed out way further in the future.

But things like the service language, which had been debated for years, about how they can't charge you more for the same service just because of the building you happen to be in, or things like pharmacy benefit managers, which we might talk in more detail in a later show, but it seems like they're getting is it just going to have to be this way of step by step, increment by increment, that they're going to try and chip away at this problem?

I think so one example that, you know, it took them 7 or 8 years to get a bill that doesn't allow non-compete for primary care physicians.

Well, finally got it this year or so, and they've been chipping away at that, you know, slowly.

Yeah, a lot of these are just philosophical debates.

I mean, we heard so many good discussions going on between Republicans.

you know, on the floor as they really try to find a middle ground in a lot of things, you know, I feel like they've done all the middle ground stuff, you know, they've done the transparency, they've tried to incentivize, they've tried to get people to do more research and choose more wisely.

And now they're kind of stuck with the more draconian measures, you know.

All right.

Time now for viewer feedback.

Each week we post an unscientific online poll question.

And this week's question is, have Indiana lawmakers done enough to help address high health care costs, A yes or B no?

Last week we asked you whether you approve the job governor Mike Braun has done during his first 100 days in office, 29% say yes, 71% say no.

If you'd like to take part in the poll, go to wfyi.org/iwir and look for the poll.

Well, a significantly scaled back bill that aims to ban diversity, equity and inclusion practices in state government and public education was signed into law this week.

Republican Senator Gary Byrne says the final measure approved by the House and Senate is simpler and more straightforward than previous versions.

Stating public universities and public schools cannot discriminate based on race, religion, color, sex, national origin or ancestry.

That's really the heart of the bill.

The bill also removes requirements that public college board of trustees must have diversity committees, and it bans public employers from requiring trainings that assert someone's personal characteristics are inherently superior or inferior.

That a person, by virtue of their characteristics, should be blamed for actions committed in the past, or that a person's moral character is determined at all by their personal characteristics.

Democratic Senator JD Ford says the bill is about twisting diversity, equity and inclusion into something they're not, and ignoring that not everyone starts in the same place.

DEI doesn't lower the bar.

It expands the stage.

It brings more voices, more talent, more innovations to the table.

The House and Senate both passed the bill largely along party lines, with just a few Republican senators joining Democrats in voting no.

Mike O'Brien is certainly where this bill started.

A lot could have changed if it had become law.

But where this bill ended.

Will Hoosiers see much change in government and schools as a result?

I think they will.

and I think as much as like the words on the paper matter, it's the tone you're setting.

We've seen this nationally.

You know, this tone has been set at the federal level.

We've already seen companies kind of dialing back, you know, pronoun use and like, just like symbolic things.

But, you know, meaningful things for a lot of people.

you know, so I think I think you will.

I mean, if, you know, we're and we talked about it before, you know, the election in 2024 clearly proved that we missed over here.

We missed over on, you know, transgendered sports and like all these kind of like one off issues that helped turn the, you know, political, the political tide nationally.

and now you're seeing it play out in the, in states like Indiana and states that are going to be aligned more philosophically.

So, but I'm, I also think we're going to miss over here too, like we did miss on the, on the on the hard end where you had Americans going.

I got to do what, you know, boss walks in, your office goes, you got to put your pronouns, your email.

And it's like, what am I what am I doing here?

we're going to miss the other direction in terms of.

Swinging too.

Far.

They've gone too far.

The other way.

And hopefully we find a, you know, we find a balance at some point.

But I understand it.

It is part of the problem here that at least on this bill, Republicans seem to have a hard time articulating what the problem was that they were trying to solve.

Sure.

And I also think that they are taking their messaging from the top down.

I think, sure, this can be, this is a bill that talks about government and schools, but this is just taking messaging to further, an idea that of of racism and anti-immigrant sentiment.

We've seen this in history before.

we've seen it definitely in Indiana in history before, in the 1920s.

That lays the ground, when people are suffering socioeconomically.

it is much easier for people who are weak leaders at the top to divide people.

And when people sometimes when I think when people are say they're antipode, they're just mad that a system is not that they are not getting services, or they don't feel like they are getting services from a system, and they're mad that they think someone else is getting those services.

And this is more of a socioeconomic like, way to, keep us from having socioeconomic solidarity.

so I think that bills like this are meant to take really complicated socioeconomic issues and use it as a blanket to divide rather than do the responsible thing, which is to lead and to find solutions.

And I know I'm talking in a big, you know, blanket term for one bill in the legislature, but that's how it works.

That's how this type of nativism, sentiment that, again, we've seen in history, with racism, anti-immigration, policy works and, it's really dangerous.

And it's something we see coming from national politics.

It's something that's being mimicked in our state politics.

And, it's something we have to pay attention to so that we don't repeat it.

Is this, you know, lawmakers kind of cut into this area last, in 2024.

It was focused on higher education then.

Now, this was obviously is pretty broad.

There's only so much they can dictate to the private sector in this in this realm.

is this it?

Do you expect this conversation to come back next session in another form?

Yeah, I think this will probably, you know, appease what they were looking for.

You know, we're not going to have Dei committees.

And I honestly, when you were saying we're going to correct on the other side, I think that's the fear.

Isn't that what the bill itself says, but that universities will be so afraid to even get near that, that simple things like celebrating Black History Month will be, you know, is that guy is just celebrating the history of women or minorities, you know, is that too much or, you know, and I've said before, I think, you know, I think what they're saying is we don't want quotas, but we're doing it, you know, in a much more big way than just saying no quotas.

Is that one of the core problems with bills like these, which is regardless of how you feel about the underlying philosophical debate over the terms diversity, equity and inclusion, and what they might mean is the bigger problem in trying to write a law that bans that stuff without also saying, well, you can't talk about black people, or you can't talk about queer people, or you can't talk about women, or you can't talk about name your your your characteristic group.

Yeah.

I mean, the tone has already been set.

The tone was set as soon as we start talking about, you can't do these things and and and everyone institutions became afraid.

They became afraid.

And we saw that.

We saw people pulling back from doing celebrations, from talking about things.

So now it is a fear of if we talk about this, are we in violation?

I think what legislators found out, though, is way more difficult than they imagined, because you have so many scholarships attached to university.

Start being afraid of, okay, what's going to happen to our numbers now?

What are we going to do when we have people who have scholarships for this, even even scholarships for their for their, former colleagues were, were at stake.

So I think they realized, well, wait a minute, let's work on a few things and not everything, but you still have now this chilling effect of what do we do?

What can we do?

Everyone is now run scared to do anything.

So I think even though the law is not what it once was going to be, it's not.

It's not as stringent as it was.

People are afraid now anyway, so they won't do those things that they used to do.

We used to have celebrations.

Now can we do Juneteenth?

You know will Juneteenth will can we have celebrations for, heritage Months?

What will we do now?

I think people are going to pull back from those no matter what.

Lawmakers revived an A to F rating system that measures Indiana's schools performance, but Indiana Public Broadcasting's Kirsten Adair reports it could face major changes before the end of the year.

The measure tasks the Indiana State Board of Education with reimagining the state school rating system.

The new framework must take into account factors like schools, reading proficiency rates, island results, and the attainment of new diploma seals.

The board can also consider other data collected by the Indiana Department of Education and additional factors it deems relevant.

The bill says schools must still be ranked on an A through F scale.

Schools won't receive a letter grade for the 20 2425 school year, but the new system must be approved by December 31st of this year and implemented by the end of 2026.

Is an A toF rating system for schools fundamentally a good idea?

Accountability is a good idea.

I don't know about the A to F. We've tried before with exemplary progress.

academic watch, academic probation, I think commendable progress.

And that didn't quite, quite cut it.

and A to F has been on the table for a while and we've been trying to revamp that to make that make sense.

I don't know that A to F is where you actually want to be and what makes this, but there needs to be some kind of form of accountability.

The A to F though I fear that there will be a division when it comes to, lower socio economic, group students who come from lower socioeconomic backgrounds as well as special needs students.

there is a fear of dividing, by putting those students in F schools based on things that the students can't control based on.

We did have a growth model at one point, but that wasn't enough.

That wasn't showing enough progress.

So now we're changing it again.

I don't think we'll ever find the perfect accountability model for schools, but I do definitely think there was some division there, and especially now that we have, vouchers, universal vouchers in play where you'll see more people taking their kids out of a school that is deemed a F school.

And many times the F rating is, does not reflect how the students and their families and the teach there's a lot of, questions about what does this f really reflect and show or what is the AA show?

A lot of times, a is for schools that are coming from a higher, higher socioeconomic background, students who don't have some of the same issues.

So that's really what the A through F reflects.

Some people believe.

Yeah.

It feels like I mean I get the appeal of F, which is you want to wait one accountability is good, period.

Two you want a way to make it easy for parents to understand, okay, is this school doing well or not?

But is it too simplistic?

Yeah, I mean, I think with any grading system that's where you get right.

I will say this.

I like the fact that they're trying to add different factors in like at one point it was literally just like one test.

Yeah.

You know, so they're going to consider the graduation seals.

They're going to consider attendance grad rate testing, you know.

So I do think the more things you put into the grade that makes it more acceptable.

But, you know, I think about like, what if we had an A to F system for lawmakers, you know, like maybe it's like attendance problems.

yeah.

Right.

Attendance.

And did you get a bill pass this session?

Obviously lawmakers would start to say, hey, hold on.

My work isn't all based on this.

Yeah.

And they would have a point.

And I think a lot of schools would have a point to in in pushing back against the grades.

That reminds me of a time several years ago when, East Chicago Democrat, Senator Lonnie Randolph was named, like, the fourth most effective state lawmaker in the country.

And that's solely because, Senator Randolph likes to put his name on.

He just adds himself as a coauthor on, like, every piece of legislation.

back to the subject at hand.

The devil, of course, is always in the details.

But on this in particular is the is the effectiveness of this rating system, whatever it will be going to be exactly what they're using.

Well, I mean, I think we like Niki said, the amount of details that they are looking at an issue like, it breaks down socioeconomically.

We have a legislature that has not done a lot on housing.

We're going to be looking at possibly, attendance rates, right.

As one of the factors, one of the factors for kids not attending school and chronic absenteeism is because kids families are unhoused.

So there's going to be a lot of complication when we look at some of those factors.

And that's why I think it's really important that when we are considering how to, assess or enact accountability, there has to be some local input and local control.

And I know that Senate Democrats offered several amendments or some amendments to do that, and those were struck down.

but we need to have portions of this need to include ways that parents can understand what's happening.

We need to have some local, buy in on how this is done because they understand their communities.

They understand what these factors, are contributing factors are, and I also think, you know.

Yeah.

I'm just going to leave it at that.

Yeah.

Well, it feels like this conversation is a version of the conversation we have every now and then with the budget, with the complexity index in the school funding formula, which is the experience of educating a child in a wealthy suburb, it's not the same as the experience of educating a child in a poor neighborhood or a rural, community or any.

These are all not the same.

That feels like the biggest problem with trying to say, well, this schools and the schools would be the schools.

To see, etc.. Well, yeah, I mean, to Niki's point, that's why you're including this, this other criteria.

But go back, go back to the beginning when we first, you know, when it was first suggested that we have an eight this is years ago now.

Yeah.

it wasn't because we don't rate schools or we don't measure schools, or it's just no one understood what the hell any of it meant.

Yeah.

You know, so, like, let's let's maybe grade it and communicate that to parents and members of the community in the way that they all understand that they 100% all understand, and that is it.

They have system, of course, complexity in that and things you need to consider.

But the, the, the key is going to be understanding why they're in a and are enough people going to go past the letter to understand, okay, why schools see that good.

Is that bad.

Well here's here's the metrics and here's how we got to that.

That's going to be well.

That's the whole point right.

It's like why is it a C. Yeah.

Right.

And how do we make it a B. Yeah I remember my third point.

And I think it's an important one.

So I'm going to weigh in.

If you take out your money you should also be considered in this type of accountability.

And you said accountability is key.

If you're taking voucher money and you're going to pull money away from these folks, you should also be.

Oh, if you're talking about the money.

Yeah.

But I think you have this a fair accountability system.

It does seem encouraging that, you know, in the previous say that if it was kind of like, okay, here's just do this, it does feel of this a little like the high school diplomas conversation we had, I think last year, which was they came out with, you know, this was a long process of determining exactly what these would look like.

And it started off and maybe not so great a place and ended up in a much better place where everybody was a lot happier.

It feels like if that's the same process we follow for this.

Yeah, but I think they only gave them till like January 1st, so it's not a whole lot of time left.

Oh, I'm sure they're already on it.

All right.

finally, the Indiana Pacers have gotten off to a hot start in the NBA playoffs, winning their first series against the Milwaukee Bucks.

And then their first two games against top seeded Cleveland Cavaliers.

They have a game.

we tape this here on Friday afternoon.

They have a game this evening.

Mike O'Brien.

How deep can these pacers go.

It's so fun to watch the best the best stat I think they you go to the Eastern Conference finals last year.

Yeah.

and they're better this year.

the best stat was in the last 20 years.

If you were if you were down seven with one minute to go in a game, those teams were three and 1003 for 1640.

The Pacers have two of those in the last two weeks.

Yeah.

That that's been a that's a bit of a story of the NBA playoffs at large.

It feels like this season.

But Nixon doesn't look.

Same way.

Does it feel just I mean obviously from Indiana does.

But does it just feel better when there's a good basketball team in Indiana?

I do, and I need them to keep going forward because the Familia Fernandez group chat is so right on nights that the Pacers are on fire.

It is so much fun.

I mean, as a family, it's just like fun to watch our family like, you know, weigh in on that.

So my hope is they at least make it to the Eastern Conference finals, because if they do, we would have both a Pacers playoff game and the Indy 500 on the same day.

Oh lord.

Yeah.

So that's city might combust.

Oh I was going to say that.

That's Indiana Week in review for this week.

Our panel is Democrat Elise Schrock.

Republican Mike O'Brien.

Oseye Boyd of Mirror Indy.

And Niki Kelly of the Indiana Capital Chronicle.

You can find Indiana Weekend Reviews, podcast and episodes at wfyi.org/iwir or on the PBS app.

I'm Brandon Smith of Indiana Public Broadcasting.

Join us next time because a lot can happen in an Indiana week.

The views expressed are solely those of the panelists.

Indiana Week in Review is produced by WFYI in association with Indiana Public Broadcasting Stations.

Additional support is provided by the Indy Chamber, working to unite business and community to maintain a strong economy and quality of life.