(Music) Holcomb still won't endorse in the governor's race.

Hospital leaders feel targeted by 2023 legislation.

Plus Rokita urging National Guardsmen to the border and more.

On the television studios at WFYI, it's Indiana Week in Review for the week ending May 19 May 19, 2023.

>> Indiana Week in Review is made possible by the supporters of Indiana public broadcasting stations.

>> This week, Governor Eric Is still unwilling to say who these endorsing in the race to replace him.

The Republican primary candidates for governor are US Senator Mike Brown, Fort Wayne businessmen Eric Doden and Holcomb's lieutenant governor, Suzanne Crouch.

>> Holcomb previously said he would hold off on any endorsement until after the 2023 legislative session.

Now he wants to extend that out a little further.

>> I am making sure that we stick the landing coming out of session.

It's still May.

>> Holcomb insists that holding off on any endorsement isn't awkward for his governing partner, Suzanne Crouch.

He says it's important for any candidate to establish that they are their own person.

>> I don't want anyone thinking that just because she and I work so closely together that she's a clone of me.

>> The 2024 gubernatorial primaries next May.

>> Is it awkward that Holcomb hasn't endorsed in a gubernatorial primary that includes his lieutenant governor?

It's the first question for our panel.

Democrat Elise Shrock, Republican Mike O'Brien, John Schwantes host of Indiana Lawmakers and Niki Kelly, editor-in-chief of the Indiana Capital Chronicle.

I'm Indiana public broadcasting to a host bureau chief Brandon Smith.

Elise Shrock, I think everyone assumes Holcomb will endorse Coach.

Is it awkward that he hasn't done it?

>> It's awkward and they have to work together and that's got to have some... ABACLE it's not like he has a lot of precedent for this because he became that candidate like four months before an election so this is new.

>> But there has to be some tension there and I guess we will have to wait and see.

>> So years, has he put himself into this position which he could have just said, I'm not going to endorse anybody.

I wanted to be an open primary I want to put my finger on the scale that why not do that?

Because everyone assumes you will endorse your running mate, why not say "Yeah she is my pic. "

>> Think about the three candidates in the primary.

What are the attack lines on each other?

Pro-life, pro-life, where are you differentiating yourself in the base and one way I think Eric Doden and Mike Braun will try to separate from Suzanne Crouch is on the vulnerabilities that Governor Holcomb has with the Republican base.

Coming out of COVID we saw that player at the convention last year.

So I think it is prudent for Suzanne to have a little space here.

To go create her own identity.

To create her own message that she has as we noted previously, tack hard to the right on some social media and some other things that what is Eric Holcomb?

Not Republican in the primary?

So I think she needs a little space to create her own identity or elevator identity from what it is as auditor or state representative.

And if you are not strategic about when these endorsements are coming, particularly the biggest one, the sitting governor, you've got to think about that and is it helpful?

That is a question.

And when is it helpful?

>> This is a question I want to ask you Jon.

Mike just talked about with the Republican primary base, and a certain wing of the Republican primary, Eric Holcomb is not the most popular guy in the world.

This goes mostly back to COVID I feel like.

There are some other, he vetoed the trans- high school sports bill last year and has done other things that have angered hard right conservatives but, is an Eric Holcomb endorsement helpful to Suzanne Crouch?

>> You know?

I don't think it would hurt, certainly the power of incumbency when you have a sitting governor yes you do have the friction with the right wing of the party, dating back to COVID and the emergency orders and a lot of things that the governor overreached and adopted a big brother approach to governance.

But what are his options?

Does he endorse Jennifer McCormick, the likely Democratic?

But if the theory is that his endorsement is bad, for Republicans, if you really want to play multilayer chess year, then he should endorse the Democrat, therefore to drive people to the Republican...

I think we are overthinking it.

I think the easiest thing would've been to simply say, especially if you are uncertain or don't have a lot of skin in the game or expend a lot of capital is say of course, this has been my partner in governance for X number of years, I would love to see a continuation of what we have built together.

Done.

There are a lot of people who don't want to see a continuation of what they built together not because of record job growth and wage increases and record investment in education, none of that stuff that >> That terrible stuff that >> Small business and Conrad Holcomb in the summer of 2020.

>> $$CAPITALISE@Jennifer McCormick endorsement.

>> If he endorses her, then you give Bron and Jodi and the chance, to the crowd, the Conrad Holcomb crowd.

But here is the primary, >> Here's the thing, let's say Holcomb never endorses that >> She is already going to get those because she is part of that administration.

I almost don't even wonder if he would endorse her or if that would hurt her because everyone who is already against Holcomb assumes she lines up with him.

On those pigs issues.

>> Or at least will be able to say that.

>> I think she is already going to get that bit so at least from the far right.

So his endorsement could help some sway for some more moderates.

>> To the point where because everybody just assumes he is for her, the fact that he won't say that he is, starts to feel like, is there a reason you don't like her?

The reason you don't trust her?

I don't think that is true.

It is an awkward position.

But I think wouldn't it have been better, I will ask you this, wouldn't it have been better for him to say I am sitting this out.

>> It would have been a lot less messy I think and I think often when you are explaining, he has gotten himself into that area where he is going to have to be explaining either way, more than endorsing.

>> He should get a job as the head of a public university.

Take that job and check out.

Then he can get out of 24 altogether.

>> Time now for viewer feedback.

Each week we post an unscientific full question and this week the question is: Will Governor Eric Holcomb's endorsement in the gubernatorial race make an impact?

And last week we asked whether you were surprised that Senator Todd Young won't back Donald Trump for the GOP nomination for president.

59% said no.

If you want to take part in the poll go to wfyi.org/iwir and look for the poll.

>> Healthcare prices in Indiana are among the highest in the nation and lawmakers try to address it with a pair of bills.

1 of them takes aim at Indian's largest nonprofit hospital systems.

>> The bills original language called for penalties if hospitals charge higher than a certain benchmark.

But the version signed into law by the governor instead establishes a healthcare cost oversight , to study a range of issues related to healthcare costs in the state and recommend ways to reduce them.

The measure also requires a third-party contractor to look at the prices of Indiana's five biggest hospital systems and compare them to a new, higher benchmark 285% of what Medicare pays.

Gloria Sachdev with the employer's form of Indiana says nonetheless, the spool two bill moves the needle significantly.

>> It's the best bill we've had ever that actually is going to help reduce prices.

>> But hospital leaders take issue with the way the bill singles out certain hospitals that they say lawmakers are not doing enough to address the states low Medicaid reimbursement rates, which they say drives them to raise their prices, or to address the role of insurance companies and drugmakers in driving up healthcare costs.

The bill also includes language to crack down on so-called facility fees that hospitals might tack on to medical bills even if the services were provided in nonhospital settings.

>> Mike O'Brien will this bill actually help lower healthcare costs for users?

>> If you believe what the hospitals are saying, yeah.

I've worked in the payer side for a long time.

Just to let you know, I was pretty involved in this over the years but what do we do in healthcare?

We buy it from Hoss bubbles mostly.

When you get the rub with lowering healthcare costs as you are reducing or bending, or reducing the increase, what you're really doing, in the amount of money you are sending to providers.

So when the providers say this will hurt us, the are right.

That was the point because we had the highest hospital costs in the country.

And we had the nonprofits sitting on billions of dollars in surplus Is what attracted the attention of the legislator, particularly the speaker of the house.

You try to do something with the start the one issue that no one really talks about because it is technical is the hospitals for a long time, there is a concept of sight of service.

What type of facility do you have?

Is it in a strip mall or is it a giant hospital.

It requires a different reimbursement rate.

Or years hospitals billed at the higher rate and make it illegal.

Congress introduced a bill this week to make that illegal.

I think it will and its most significant bill they have passed.

And there are some unique concepts in here that the rate, of huge For they have some skin in the game to pave the outcome.

Whatever the patient outcome is affects the reimbursement rate that it was pretty creative that how the house in particular and the Senate in the second half of the Senate -- session, if you believe the hospitals it will have an impact.

>> So the hospitals, some of them I think, there like there is nothing wrong with our prices whatsoever.

Some hospitals are like yeah we need to collectively look at the start the hospital problem seems to be your only looking at us.

Is that the biggest issue with this legislation?

>> I think one of the failings of the whole process is the fact that the hospitals were called into question.

Not the insurance companies.

And not the pharmaceutical companies.

They weren't brought to the table on this at the same rate.

Hospitals also said "Hey, Medicaid reimbursement are a big problem when it comes to passing on costs " that Medicaid reimbursement lighting in Indiana, they afforded some relief to practitioners but not the hospitals.

That is a problem.

So, this bill has some good stuff in it, sure.

Moving the ball forward but there are some ways that it is really lacking and I don't know that because of that we will see certainly not an immediate impact but I'm not sure it is going to help in the way that people are really struggling and need that help.

>> As of this week we are home to the most valuable drugmaker on the planet.

>> Is that part of the problem?

Is the fact that there are some influential insurance and drugmakers here in Indiana.

>> There were some other bills, there was a pharmacy benefit manager bill that looked at some of these issues.

>> I want to talk about that more.

>> There were some other bills that I think all of them, if you looked at all of them as a package, they obviously started very aggressive and kind of slowly pulled back.

On one hand, if the hospital, you could say in your mind, if hospitals are so scared, then it must really have an impact right?

But on the other hand, and what I heard from some lawmakers especially in rural areas, is that they are worried about hospitals and providers will say "I'm out ".

And we already live in a state where most counties in this state don't have a hospital.

So there is a fine balance between what lawmakers are trying to do.

>> To that and then, because that is part of the concern here, this bill in particular really only targeted hospitals.

So as Nikki pointed out, this was a lot more aggressive when you're talking about penalties that that is significant.

And they pulled way back from that to "We will have somebody look at them and them will have a task force look at them".

Did they pull back too far?

Or did they pull back enough to make sure that hospital stay open?

>> That is the big question.

Keep in mind as we've discussed before, this is not a Republican versus Democratic issue.

It is much more geography-based and is my district home to a hospital that fits this description and would be in a precarious financially position if this had been enacted as originally introduced.

>> It is no surprise why hospitals were the target here.

The surplus that we heard so much about,... >> Particularly at nonprofit hospitals that >> Some nonprofit hospitals which is another point probably makes us even more complicated.

But when you look at, as you pointed out in the open, the reimbursement, I should say the cost is among the highest in the country but physician reimbursements are among the lowest if not the lowest.

So if you look at those two factors alone, and I know there are other issues, but if doctors are getting the money, where's the money going?

It is going into the system and where does it come out?

It makes an easy target but the other point is that you are right, nonprofit is not nonprofit is not nonprofit.

There are those that are barely scraping by and there are others that were in a position to give half $1 billion contribution to for instance the IV medical school.

And trying to come up A mechanism that encourages cost efficiency across the whole spectrum is pretty tough because they don't look like and don't operate like that >> Hospitals don't exist in a vacuum.

Healthcare field is much more vast.

>> Some of what leads to incredibly high healthcare costs in Indiana is we are an unhealthy state which is partly why we are doing this public health Bush and mental health push and all that done it is good.

Let me ask you won last question Mike, is this it?

Are they going to take a little bit of a...

I don't mean ever but is this like OK we've done something let's give it a few years and see what happens.

Are we coming back next year?

>> I think this is pretty significant.

This was a huge lift and undertaking by a lot of legislators in the House and Senate and both parties.

There is always something done we are always around the edges of one off healthcare problems and experience in what had they didn't like that >> I don't think we'll have a choice, we are doing the unwinding from the COVID era, Medicaid eligibility and so, >> That's the next problem.

>> The argument you made is the same one hospitals advanced at the beginning of the session saying we are waiting for some of the earlier prescriptive measures tht were imposed earlier to bear fruit.

We are not there yet.

So already we are making the argument even before this legislation was enacted.

>> Attorney generally -- attorney Attorney General Todd Rokita told WIS HDV, that Governor Eric Holcomb should join a few other Republican governors in sending National Guard and law enforcement personnel to the country southern border.

>> Texas Governor Greg Abbott recently sent a letter to the nascent governors requesting support in immigration enforcement after the Biden administration lifted title 42 is pandemic your policy that had shut down almost all avenues for migrants to seek asylum in the US.

Holcomb and 23 other governors reluctantly signed onto a statement from the Republican Governors Association supporting Abbott's efforts on the border.

>> A statement supporting That a lot of Governor signed onto his wanting, personnel and resources are an entirely different thing.

What does Holcomb do here?

>> Right now they are standing pat.

I reached out this week and asked and they said, "We have had 22 National Guard members down here for maybe the last year.

As part of a smaller issue but...

It's part of a federal mission so they weren't really in charge of that order.

But right now, they don't have any plans to do more to I think, yeah, I think he's in a tight position on that one.

Because other states are starting to react and send down there.

And Todd Rokita especially is making it hard for the governor.

>> Would making this decision, let's not pretend that politics never enters the governor's mind while making a decision as much as he might say otherwise sometimes.

But is making it easier for Eric Holcomb who is not running for anything in 2024, not as far as we are aware that so that politics here don't impact him nearly as much.

>> They probably don't impact him as much as those individuals who are running and trying to advance the narrative that there is a crisis.

An unprecedented crisis on the southern borders and this is a threat to our very democracy and existence.

Which most accounts suggest that is not the case.

There is another big problem here about the legality of these individuals that now, you can use generally speaking, guard individuals men and women in law enforcement roles.

Some states have said, we won't send our National Guard troops, we will send state troopers or we will send criminal investigators.

There is no certainty they have any legal authority in the state of Texas.

And in fact, there is a pretty large contingent of legal, a scholarship that suggested they try to make arrests of people that are crossing the border and so forth, they could be subject to wrongful arrest or essentially, legal challenges that for an improper arrest where they have no authority.

And because of that, and Texas I think even recognizes that, you have Ohio State troopers in the past year that essentially because of this issue were cleaning out the horse stables.

The manure in the horse stables that the border patrol agents used.

So I guess that frees up agent to clean out manure in the barn but it's not as if they're going down to be the frontline Vanguard of defending the borders that >> Manure in the barn start >> Let me ask this question because I think the average person thinks of the National Guard and law enforcement very differently.

We often see the Indiana National Guard being sent to other states to help with disaster recovery and that's an important function in the National Guard place across the country.

Sending them to Texas to do something to the average Hoosier would go, we send them to other states all the time.

But sending Indiana police to another state and theoretically then taking them away from Indiana and protecting people here at home, is that a good idea?

>> That's a consequence of doing that for sure.

What I think Todd Rokita has a point.

>> That hasn't been set on this show.

(Laughs) >> This has changed drastically, in April 2020 there were 17,000 border crossings and in 2023 there were 211,000.

The argument that why would Indiana redo that?

It's in Arizona or Texas problem.

The argument is, this is starting to affect all major metropolitan cities.

As the sheer volume of the migration coming in, they're going to El Paso but they are going everywhere.

I am not saying that we should send National Guard for that reason that it depletes resources here but it does call into, it brings into focus that this is a national problem that it is not a southern border state problem anymore.

>> It has been and we've needed immigration reform for a long time.

The fact that the notion that these types of immigrants coming in and people who need to seek asylum and are looking for a better life is everyone's problem is not a Todd Rokita thing.

That is a collective... >> I don't want to get out of this topic without asking the question, I will ask you.

A lot of the attention right now is because title 42 ended, you can feel one way or another about whether that policy should've been in place this whole time or whether it should still be in place, but it ended.

You are seeing a greater influx of migrants, some people think it's a good thing.

If you are an asylum seeker we should give you shelter.

Is this a huge feeling of the Biden administration to not at least be more visibly responding to what is clearly a crisis?

>> I think every administration over the last couple of decades that has failed to move the conversation forward or past immigration reform, has failed.

It is a critique you will hear of the administration from my community, the Hispanic and Latino community, so we need to do more than back to the question at hand, is sending our state resources down to some Yosemite Sam mission by Texas governor, the answer probably not.

And I think there is a lot of fear mongering when it comes to this issue that happens in our state that many people have bought into it.

But it is usually a political statement.

It is not actually sending our resources that that is why I think the difference in the conversation.

>> A national and federal problem are not synonymous and that is why we don't have states sending up their helicopters to intercept Chinese surveillance balloons.

>> And I am waiting to see... For political reason, what if a president who is a commander-in-chief tells their National Guard unit to do something other...

Which is when you have a constitutional crisis.

That is why generally speaking, these are, this is a federal domain.

Traditionally done >> It feels to me again, I don't know what the Biden administration is doing here.

Maybe they are doing something but I don't think we know what that is.

That in and of itself is...

There is a lot of politics going on here but if a bunch of people in conservative states the federal government trying to address the issue in a more significant way to respond to this, I will quality crisis, whether the people should be here or not it is a crisis.

So without them doing something - more visible, it feels like at least, leaves the door For folks to say we have to go do something.

>> It is a continuation of a very dangerous political discourse that it is heaped on top of that.

>> Finally the state unveil some new highway signs this week that welcoming people to Indiana, the new signs incorporate the tourism campaign in Indiana by reading more to discover in Indiana.

What is your in Indiana pitch.

>> Race in Indiana?

>> I like >> Especially since were doing ahead of the 500.

>> Try not to make the joke of going backwards in time.

>> That tourism campaign brought up a lot of that from a lot of people.

>> I only have things I can't say publicly.

Everything in my mind are inappropriate things that >> That was the struggle with the in Indiana campaign got >> Take it all in and a lot can happen in Indiana mild.

>> Today have to pass for that?

>> That's why I am suggesting it.

That's Indiana Week in Review for this week that our panel is Democrat Elise Shrock, publican Mike O'Brien, Shortness of Indiana Lawmakers and Niki Kelly of the Indiana Capital Chronicle.

You can find Indiana Week in Review podcast and episodes at wfyi.org/iwir or on the PBS video app.

I'm Brandon Smith of Indiana public broadcasting.

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

(Music) >> The opinions expressed are solely those of the panelists this was a WFYI