Proposed therapy cuts under Medicaid.

Health leaders warn public funding cuts.

Plus Governor Braun's helicopter trips and more.

From the television studios at WFYI, it's Indiana Week in Review for the week ending August 22nd, 2025.

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

This week, people with disabilities could face significant cuts to therapy services if Indiana's proposed changes to Medicaid waivers are approved.

WFYI's Ben Thorp reports lawmakers and advocates gathered recently at the statehouse to oppose the reductions.

The state is proposing changes that would cap music and recreational therapy services to just six hours a month.

Advocates say that is a significant cut to the time that gets people out in the community doing things like going bowling, going out to eat or playing music.

Kendra Hummer has cerebral palsy.

She says the waiver has helped her feel less alone.

If these changes go through, it will be.

Devastating.

For me and my entire community.

The state has 30 days to review public comments before submitting the changes to the centers for Medicare and Medicaid Services for approval.

If approved, it would take effect next year.

Is the state cutting too much to fix its budget woes?

It's the first question for our Indiana Week In Review panel.

Democrat Ann DeLaney.

Republican Mike O'Brien.

Jon Schwantes, host of Indiana Lawmakers.

And Oseye Boyd, editor in chief of Mirror Indy.

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

Mike O'Brien.

Is the state cutting back too much?

I think what they're trying to do is preserve the core services that have to be provided to the population that needs it most kids, pregnant moms, and the elderly and disabled.

so they're looking for places at least here or we're Indiana is an outlier in the services that are provided.

So for these types of therapy services, only six states in the country do this.

And five of the six, including now Indiana, put limitations on it and put caps on it.

And so that's what's happened here is have been completely taken away.

Of course, they'd want to provide more if they if they could.

It's not the price of bowling shoes rent bowling shoes that drives the cost of it.

So it's the providers and the other support systems that are, that are around it.

So it is it is significant.

But it's it's in the interest of preserving the existing program and that most essential services, at a time when there's budget uncertainty here, the program's never been bigger.

Health care costs have never been more expensive.

And we don't know what the feds are going to hand down here down to us two.

So all those factors are in play are not great.

And cutting these services isn't great, but right sizing it.

But it is starting to affect, as we always talked about, other parts of the budget, K-12 education and other priorities.

and so you got to make you got to make hard decisions about.

Is this simply a budget reality for Indiana?

It's not a budget reality.

It's a choice.

Okay.

Are they they are still cutting corporate taxes.

They're still cutting income taxes.

They're still giving vouchers to people who don't need them for private school education, in fact, are expanding that.

So it's a choice.

It isn't simply that there is no alternative.

There are alternatives.

The Republicans just don't like the alternatives.

They'd rather give to the rich and take from the more vulnerable, which is what this is.

And we're going to lose hundreds of thousands of people off Medicaid, off Medicaid by the time the Republicans in Washington get done.

It's going to be a disaster for Indiana because so many people in Indiana receive Medicaid services, and that's going to drive up the cost of health care for everybody else, because they're going to go to emergency rooms, and the costs are going to be passed on to the people with insurance.

And that's a choice Republicans are making.

And don't make it, anything other than a choice.

This is always the problem with trying to, address a budget problem through Medicaid, right?

Which is no matter what you cut, there is going to be a very like it's a it's a difficult story to tell, right.

Yeah.

I think it's a matter of priorities.

We do have to fix the budget.

We do have to figure out Medicaid and what's going on with Medicaid.

But I think part of the problem is, and I keep saying this over and over, because it rings true for me, is that when you look at Medicaid, we also need to look at the whole health system in general and the high cost of health care and where Indiana ranks in health outcomes poorly.

So therefore, we're going always have higher costs of of anything when it comes to medical care.

So how do we fix that?

Well, we keep fixing it by saying we're going to cut here.

But we never really looked at the very beginning of the process.

How do we become better as a state in general?

I know we're I'm jumping ahead of us a little bit because we're going to talk about some other things, but all these things to me just all go together.

And when we're talking about we keep cutting, cutting the budget, fixing the budget on the backs of the most needy.

I know you're saying it's an outlier, but we need to be an outlier when we're doing the right thing.

Sometimes just because we're the only.

We're one of six states.

we should be proud to be one of six states when we're doing something that actually helps our helps our Hoosiers, helps our residents live better lives.

And that's what this is really about, is living better lives.

as we heard in the, in the introduction, how it harms the community, people feel alone.

So how do we help people to I mean, not feel alone.

If you're one person who's dealing with, medical issues, you also need to be around community.

You need to have a social life.

All these things are important for quality of life.

I mean, this this reminds me exactly of the attendant care issue, which is it's one of those things where the state had been offering this thing.

In this case, it's it's these therapy services without limitations.

In the case of attendant care, it was it was family caregivers being allowed to care for their medically complex children at higher reimbursement rates.

And so what the state said is we're not going to get rid of it entirely.

We're not going to stop you from doing this entirely.

But we need to try and rein in our costs.

So we're going to, on the attendant care thing, reimburse you for less on this.

We're going to put a cap on it per month any time you're taking back something people have already been getting.

Are you running into trouble?

Sure.

That's I think that's the one certainty.

And in our ever changing political system is that once people have benefits that they have grown accustomed to, it is hard, to take those away.

we've seen it time and time again.

And I would say, let's take this discussion and clip it, note to the control room and save it, because it's going to have a very long shelf life.

I think this is going to be a discussion that comes up again and again and again, because this, is just what you call the outlier, something.

These are the easy cuts.

Arguably not.

I'm not saying they're easy for the people who are affected, but in the scheme of things.

But you're talking about, according to the Congressional Budget Office, possibly $1 trillion in Medicaid cuts nationally over the next decade.

And don't forget, we're partners with the federal government.

And when the federal government cuts funding, guess who has to shoulder the responsibility?

It's the cuts.

So there are make cuts.

It's and and I think the temptation is to think that Medicaid is helping somebody else.

at some point, small population of pregnant women or needy children.

Well, actually, I just looked at the newest numbers.

26 of every who hunt 100 Hoosiers are enrolled in Medicaid, which is above the national average of 23 per 100.

So when you talk about, you know, statistically, one of us at this table or more than one is enrolled, it's not just some other population.

So I think as we see more cuts affecting not just recreational outings but fundamental care, yeah, this will almost seem quaint in comparison.

Earlier this year, Indiana lawmakers significantly cut public health funding in response to the bleak budget forecast in Indiana Public Broadcasting's Abigail Rubin in their final report for us, says that health care leaders say the loss of funding will likely slow efforts to address health care costs and outcomes.

Indiana's historic public health funding was scaled back in the final version of the state budget, dropping from $100 million to just 40 million for all 92 counties.

Mike Shroyer is the president of Baptist Health Floyd in southern Indiana.

To address high health care costs, Shroyer says the state needs to invest more in chronic disease prevention and public health.

And unfortunately, in this last legislative session, they.

Decreased.

The funding for public health.

So we kind of went in the wrong direction in that way.

90% of the country's health care expenditures are for people with chronic and mental health conditions.

Shroyer says Indiana's population ranks poorly in most health outcomes, which means people are more likely to have and develop chronic conditions.

Ann DeLaney, state lawmakers were not opposed to the public health funding program at all.

but and so they indicated a willingness to continue the program as much as possible.

So if lawmakers can come back in the next state budget and God willing, it's a lot better than this last state budget was, if they boost the funding, then will that help mitigate any temporary setback we see here?

You know, if they're the gutless wonders I expect them to be, they can come back for the special session and fix this.

Or maybe we can have a. Yeah, yeah, that list of special session desires is growing.

Well, you know, I mean, why not?

I mean, these are more real problems than redistricting as.

Certainly.

And I don't know whether they can undo the damage they do when they do this.

Stop start.

And people are reluctant obviously, to, to, rely on an analysis session because it can be ripped back, right when you start laying the foundation for spending the money.

And to go to the point, oh, she was making earlier, this is this is exactly the wrong approach.

We know we have an unhealthy population.

We know our health care costs are too high.

This is designed to help in that regard, to identify potentially chronic illnesses earlier and treat them in a much less expensive way.

And what do we do?

We cut it.

I mean, it is the senseless kind of approach that that legislature always takes on these cases.

I mean, this is something to that.

Governor Mike Braun is really behind.

He loves focusing on preventative care instead of treating, you know, illness later because it's a lot cheaper on the front end than on the back end.

So is this something that can and should get a boost if the budget situation improves?

I think it can.

I went back to the Senate bill for, back in 2023, and it had the entire Democratic caucus in both chambers and large percentage of the Republican as coauthors.

But so you try to if you think, okay, also, if the funding comes back, what do we do?

One, they tried to they tried to resize it to what?

Okay.

What programs have you already put in place?

What money are you already spending.

We're going to fund that the next, you know, phase three.

Hold on a second.

Right, right.

That that was that.

So it was a it was a cut and that the anticipated spend went down, but it wasn't cutting.

Anything that they were already doing was it was the goal.

so if it comes back and the governor, like Governor Holcomb, took a lead.

Right.

And it was an unusual time that for a Republican governor to take a lead in public health.

You remember the context.

We were coming right out of Covid.

You had rollicking governors all over the country taking punitive measures to cut especially local public health.

so it was pretty extraordinary effort back when they did it.

and it's going to take leadership.

It's going to take a champion of the legislature to, to try to pick it up and put it back to where it was.

This is another one.

It harkens back to the the question I just asked you in the last topic.

So let's say I agree.

I think there are a lot of voices in the General Assembly.

And I think even Governor Braun has talked about this as an example of what we should be focusing on.

So there would be voices who say if the budget situation is better, let's let's grow that so we can do more of that.

But then you fall into the trap of if it gets, if it's the first thing on the chopping block, when the budget gets tight again, how can anybody know there's a lot of.

That chopping.

Block?

Well, there was this whole no, this year there was.

Now, believe me, I'm well aware there was a lot on the chopping block, but.

Well, if you take that to the extreme, government wouldn't do anything.

Why repair a road?

Because you'll get accustomed to being able to drive from point A to point B without your tires, wheels falling off.

I mean, at some point you do have to invest, even if there is a risk, as there is with everything, that funding may tighten in the future.

I think Mike makes a good point about this.

Not I wouldn't break this down as an R versus D issue.

It's clearly not.

In fact, if you look at the task force, that's been a couple of years, looking into public health in Indiana, which had been overlooked for probably a century.

in many ways, I want to say that there were a lot of prominent Republican.

I think Luke Kennedy, former state senator, was involved in that.

and then you look at people who actually authored the bill, I think it was Mike Kreider.

Senator, I could be wrong.

And other than Charbonneau.

And Charbonneau, I'm not going to leave that out.

but Republicans, and they were they were adamant and vocal about, saying this.

So, if anything gets additional funding when things, grow rosier and we hope they do, I think this is at the front of the line.

Long as it doesn't interfere with vouchers, tax cuts.

Mike.

Mike credit.

Just the one in the Senate who's taking the lead on mental health.

okay.

But, Health is good health.

Yes.

But I will always say, and I'm only half facetious about this, as long as we call it public health.

There will be enemies.

Because people, like, conjures up notion of something else.

Call it anti-drug pro.

Vaccine.

Pro, pregnancy pro and and all of a sudden it has a different feel for it.

And mentioned this already.

But it is gets exactly to what you were talking about in the last topic, which is, if we need to, all of the problems in health care that we talk about in this state, not that high health care costs are unique to Indiana, but Indiana has some of the worst.

all of this gets back to if we can make the state healthier at a core, everything else gets easier, right?

Yeah.

I mean it's we've been talking about obesity and Indiana's health health crisis for a long time.

And we're finally moved into the direction of doing something.

And then we get the cuts.

I understand that things have to be cut.

You have to figure out where to cut to your point.

Not not vouchers.

I didn't want you to say before I said it.

So it's not vouchers, but things had to be cut.

I mean, I feel like legislators, had to make some tough decisions.

We know they did.

And this was probably one of the tougher ones.

But when we look at where we want to be in Indiana in the future, we want to be healthier.

We need to be healthier for Indiana's sake, not just because, it's, you know, it's economically it's economically better for us to be healthy than unhealthy because the costs are so high.

Astronomical, rather.

but hopefully we do get back to putting this back on the table and putting some more money back into because we were just beginning to see gains.

Yeah.

Or at the Indiana Capitol Chronicle reported this week that governor Mike Braun has taken 11 helicopter flights to and from his home in Jasper in the last six months.

The Capital Chronicle story details that the flights on the Indiana State Police helicopter cost taxpayers nearly $24,000.

But the Braun administration argues that cost would exist anyway because pilots must fly a certain number of hours each week.

Under both Federal Aviation Administration and state police standards, the Braun family home in Jasper received a security upgrade earlier this year, including a $1,700 helipad.

Oseye, is this really that much of an issue?

Depends on who you ask.

It depends on who you ask.

as a journalist, I'm always interested in how taxpayer dollars are being spent.

I understand the rationalization here.

The span of where they're going to have to fly anyway, so why not take the governor where he needs to go?

but I don't remember past governors building a helipad.

Well, past years largely.

I haven't lived entirely in the governor's office or nearby.

The case of Mitch Daniels.

So, Well, we have a residence here in the city.

Am I correct?

Yep.

So that was built for governors to actually live there, no matter where you're from in the state, you have a place.

So I think I made my point there that he can actually live in Indianapolis and he wouldn't need a helicopter at all.

but I think, though it seems when we're talking about cutting, we're talking about making cuts in Medicaid and public health, we're talking about all these different things except for vouchers.

it looks a little bit like a luxury.

so I think it's more about the optics.

And if you're asking us to cut here, but then you're riding around a helicopter.

I don't think it's a good look.

Yeah.

Two years ago, when we couldn't spend money fast enough in that state budget, in part because of a huge influx of federal funding and all that.

This feels like a completely non story.

Is it because it's in the shadow of the current budget that it feels more of an issue?

Sure.

When spending when dollars are tight, these kinds of things get attention and it's a legitimate story.

To your point, I think the public has a right to know what how their tax dollars are spent.

However, I will say there's not the hypocrisy, issue here that sometimes comes up with these kinds of stories.

As far as I know, Governor Braun never attacked the use of helicopters or pledged not to.

And I compare that.

Because I I'll use.

I compare that back to a campaign that and ran when Evan by a successful bid for governor where he had awarded a golden faucet sort of a take on the Golden Fleece to Bob or his predecessor for flying around on this supposedly beautifully tricked out equipped, beach King air, and made hay out of it politically.

And then I went back and looked after about six months into that by administration, I don't remember the exact number.

And guess who used it more than Bob Moore had?

It was Evan.

Bob.

I got rid of it too.

Probably after that story, but.

I think.

You're giving yourself more.

Credit.

Well, but that to me, when politicians act in a manner that, departs from what they have said or displays hypocrisy, I think that moves it to a different level.

Having said that, I hope the public pays attention to every expenditure because it's their money.

I mean, $24,000 is a lot to me in my personal finances, but when you're talking about the state's coffers, it's a drop and a drop and a drop in the bucket kind of thing.

Right.

Well, the only thing I learned in the story is how cheap it is to fly in a helicopter.

I thought it was.

I thought it.

Was gonna be 20,000 a trip.

No.

And the.

Helipads.

Hilarious.

That's.

That was in a field where he cut the grass himself, and they dumped a bunch of rocks and nothing is circle.

That's where it lands.

This isn't like some, you know, it's these lying on top of a skyscraper in Jasper.

not a ton of skyscrapers.

And I think the state police did it the right way.

They got they got to go for hours on this helicopter anyway, so why not just manage it?

So, you know, we can do these trips.

It's 11 trips in eight months.

I was just going to say 11 trips in the last six months.

Six months?

that that doesn't feel like an excessive.

I think it's the kind of story that makes a difference in an election.

But I think she is right that that when you're when you're talking about that child with cerebral palsy, you're not getting the kinds of services she wants.

It just doesn't play well.

Yeah.

So it's more of an outrage.

In the more the more he should have waited until they were cash rich to do it.

And then nobody probably would have even noticed.

All right, time now for viewer feedback.

Each week we post an unscientific online poll question.

And this week's question is our governor Mike Braun's helicopter trips to his home in Jasper a problem, a yes or b no?

Last week we asked you whether Indiana's latest I read scores show that the state's focus on literacy is making a difference.

67% of you say yes, 33% say no.

That's I was a little high there.

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

Well, Indiana, speaking of health care again, Indiana ranks 11th highest in the nation for the number of residents with medical debt in collections, according to the urban Institute and state lawmakers, leaders and advocates took a first step this week exploring the issue of medical debt and potential solutions.

Advocates say Hoosiers have an estimated $2.2 billion of medical debt in collections, and they say that debt causes people to delay or forgo care and strength their ability to pay for other necessities.

Dave Almeda is with the Leukemia and Lymphoma Society.

He says part of the solution is better education.

About billing appeals, payment plan options and charitable support all made up, says Indiana.

Lawmakers should also address what he calls egregious collection practices, such as the seizure of a primary residence or a primary vehicle, or the seizure seizure of income.

Through wage garnishment and capping interest rates on outstanding balances.

But collection industry leaders like Heather Guild say wage garnishments and liens are what ensure debt collection is possible.

The better solution is to preserve reasonable collection tools while ensuring that the safeguards already in place are promoted, understood and used to their fullest potential, Guilbault says.

An example of those safeguards is the existing cap on wage garnishment that limited to between 10 and 25% of a person's take home pay.

Jon Schwantes, with the political realities of Indiana, is there an achievable solution in the legislature that can make a difference on medical debt in Indiana?

Well, with your caveat referring to political realities, I guess universal health care is out the window.

Probably okay, because universal health care would would solve the problem.

I'm just this problem, maybe create others.

But but that's a great the Medicaid.

That's that's why my my qualifier was achievable.

Yeah.

So there you look at what other states have tried.

You look at what the federal government, the ill fated Consumer Financial Protection Bureau in the waning days of the previous administration, had, put forth a rule that would have prevented, debt from going on your credit record.

and a judge subsequently just recently struck that down, said, and other states, though, have I don't know who's enacted it, but other states have looked at state level.

provisions along those lines, the idea being that if you're already, drowning in debt and it shows up on your credit report, then you're meant to get it hard to get to work so you can get a job to pay the debt, or to live in a place that's within a reasonable distance from your work place, etc., etc.

that doesn't happen.

So then you spiral and it just gets worse and worse.

But political realities then ain't going to happen either.

In this state.

So no, there is no answer, I don't know.

This has gotten traction.

Well, yeah.

So I wanted to so this was the reason this is a study committee.

So the way the study committee process works is the four legislative caucus leaders, vote on the topics that they're going to study each year.

And in order to be on the the list of topics, three of the four caucus leaders have at least three of the four caucus leaders have to agree to study it.

This was, in part, a letter that House Speaker Todd Houston sent to himself, I guess, to say, hey, we need to study this.

So is there growing bipartisan momentum for something to happen here?

Oh, I definitely think so.

in this day and age, when we're seeing so much medical debt going back to the fact that we're in an unhealthy state, and then we have poor health outcomes.

Also, we are we are in the hospital a lot.

And when you think about there are there are ways to actually address the debt.

As the woman in the story said, you can you can create a health plan, a payment plan.

Some people don't know that.

People do not know there's financial assistance.

People do not know that you can create a health plan, a payment plan.

and when you get those collection calls, you kind of feel pressured to go ahead and make the plan, to whatever number they say versus what you can actually afford.

Yeah.

And then when you, when you miss your payments, you're, you're in debt even more so it becomes a thing where you want to lean against your house or how are you going to pay for this?

it becomes scary for people.

That's why they don't answer the phone call.

That's why they don't know what, because it's scary.

It's a very scary thing.

And there probably still a lot of them are still sick.

You know, when you're still getting treatments for cancer, you don't really care about the bill.

A phrase that was brought up in the committee discussion.

The select committee discussion early this week was personal responsibility.

And I think, you know, when we talk about, like, student loan forgiveness, a lot of the Republican resistance, that is these people chose to take on that debt.

They chose to go to college.

They had other options in not a lot of choices.

If you suddenly get there's not a lot of personal responsibility, but when you.

Get paid, you know, I take issue also with the student loan comment is the government guarantees for profit institutions as well, and they make a business of seeking out people who are more vulnerable and promising them the moon and starting interest rate on the student loan debt on the day they enroll, but.

Medical debt even more so.

Medical debt you don't have control over.

Not only don't you have control over, the odds are good you're going to lose your job.

So whatever ability you had to go on a payment schedule or do something is gone.

Which is part of the reason that, bankruptcies, chapter 13 bankruptcies in Indiana are up dramatically is that the two common combined forces are student loan debt and medical.

Does it feel like there's growing bipartisan momentum here?

Well, yeah.

And I think if you combine with the legislatures already done in large part driven by Republicans, it's a two sided argument.

You got to hit it from both sides.

You've got medical debt that what do I do with this debt.

How do I get out of this debt.

Right.

How did I get into this debt right.

Medical debt itself is is a is confounding because you don't know you're getting into it until you're in it large times, which is why the legislatures focus on transparency.

That's all good.

But what happens when Medicaid, when people get cut, when we lose 2 or 300,000 people, that number is going to be discharged.

I don't know, they're awesome.

Yeah, it can be all right.

Unlike student loan.

Debt.

That's Indiana Week in Review for this week.

Our panel is Democrat Ann DeLaney.

Republican Mike O'Brien.

Jon Schwantes of Indiana Lawmakers.

and Oseye Boyd of Mirror Indy.

You can find Indiana Week In Reviews podcasts 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.