(Music) A judge invalidates Indiana's Medicaid expansion waiver.

The U.S. Supreme Court gives presidents broad immunity.

Plus, Donald Rainwaters property tax proposal and more from the television studios at WFYI.

It's Indiana Week in Review for the week ending July 5th, 2024.

Indiana Week in Review is made possible by the supporters of Indiana Public Broadcasting stations.

This week, Medicaid members on the Healthy Indiana plan will not have monthly payments for the foreseeable future.

The Family and social Services administration made the announcement after a federal judge vacated the 2020 approval of an Indiana medicaid program over a number of policies that act as barriers to coverage.

The ruling stems from a lawsuit filed against the federal government.

It said a number of policies within Hip restrict access to coverage and services, including power account contributions, which are monthly payments required to access the version of Hip with better coverage - Hip plus.

Nonpayment could result in being knocked down to the basic plan or losing coverage entirely.

Indiana medicaid Director Cora Steinmetz says Indiana does not agree with the ruling.

While Hip members remain covered today for Medicaid.

The ruling creates uncertainty regarding which services are covered and removes authority for certain administrative aspects.

Of the program's.

Operation.

The judge that issued the ruling said that because Medicaid members derive their eligibility through Indiana state plan, they would remain eligible even with the vacated approval.

FSA says power account contributions, as well as co-payments, will not be required while it explores legal remedies in response to the ruling.

Cost sharing, including co-payments and premiums for the Children's Health Insurance Program and Med works, will resume as planned.

Does this court ruling throw Indiana's Medicaid situation into chaos?

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

Democrat Elise Schrock, Republican Mike O'Brien, Whitney Downer, senior reporter for the Indiana Capitol Chronicle.

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

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

Mike O'Brien, we've talked about this a lot on the show.

We've been talking about Medicaid a lot on the show, as lawmakers and policymakers have been talking about major changes to the program because of how expensive it's getting.

How do you move forward with this ruling hanging over your head?

Well, so whenever we talk about these Medicaid stories, most recently with the caregiver situation, the changes being made there, it we're always talking about people's lives, vulnerable populations.

That's of course all true.

What's also true is you're trying you also have to solve a political problem for this program, which we solved by structuring up medicaid expansion population in a state that did not want to expand Medicaid under Obamacare.

And we did it on the basis of a previous Medicaid expansion before President Obama was even even elected under Mitch Daniels, who expanded Medicaid to begin with under the original Healthy Indiana plan.

You've sold that politically, and we expanded Medicaid under Obamacare, which I'm not even sure every lawmaker would even know they did.

But we were expanding the program.

That's how it was.

Always message were expanding.

To point out we're not expanding Obamacare into, you know, Medicaid expansion.

The Obama administration at the time went along with it because Indiana was a red state.

No red states were going to expand Medicaid.

But we had this separately branded Medicaid product that we could go sell.

And the way it was sold to legislators and the administration was this isn't just welfare.

This isn't just health care that's paid for by the government.

This is a program that requires the enrollees to have skin in the game.

If it was a HSA styled, the power count was intended to be what an HSA is to a commercial health insurance policy.

And that was and that was successfully sold to lawmakers and to Hoosiers, who were skeptical about expanding Obamacare at the time.

and so it's important to remember the political problem that was solved by expanding Medicaid the way we did in Indiana.

So this is thrown in the chaos?

No, I mean, worst case, I mean the worst case scenario from the state standpoint, as we go back to a world where premiums weren't paid.

But we also changed the program to create a wealthier benefit for the enrollee if they participated in that, in that program.

And that was a benefit to them, too.

so we'll see what the path forward here is, what the reaction to lawmakers is, what the legislature is already because of the money, right?

Because of the money involved, the Medicaid funding shortfall and the fact that this program is growing, finance is taking up a larger and larger share of the budget already paying attention.

So I'm sure there will be a reaction in 2025.

It is part of the problem here as lawmakers try to figure out what that reaction is, that I mean, this is not the final ruling on this subject.

Sure it will.

And the political history that you laid out is accurate.

But the thing is, this is a living and breathing thing.

And there are many things that have changed since then.

the, public input that we're hearing largely from people from southern Indiana is that these payments are barriers.

And we've seen that these are barriers largely for people of color.

so as this, program has emerged, we're hearing how it works and how it doesn't work for certain people, rural areas, people, again, of color.

We are also seeing more and more people age in Indiana, more and more people becoming eligible.

We're seeing a lot of different things happen over the last year with Medicaid, where, the system has been a bit clunky.

So this program is expanding, and even the Medicaid director, herself said this is a multifaceted program.

And as this price keeps ballooning, Indiana and the legislature needs to look at this not just as a medicaid issue, as a funding issue.

We're going to have to start looking at the whole health of our state.

What are the other policies we can put in place to address, like when we're addressing this?

When people turn 60 or 65, it's too late.

Yeah.

What can we do to make sure that people are aging well?

What does our quality of water look?

What does our quality of place look like?

What type of trails do we have that are accessible to people?

What type of rural health care are we affording Hoosiers?

Like, this is a big thing, and when we're paying it on the back end, it will keep ballooning.

We're rearranging the deck chairs.

And that was and that was partly what the public health funding initiative that we'll have.

We'll see what new funding, if any, they give for that was involved will involve.

And I just want to kind of mention that even the state itself is skeptical whether having this program is beneficial.

You know, you're bringing in very tiny amounts of money.

Sometimes it's a dollar, you know, $10.

And how much are they paying to administer that program?

And the state is not able to give you a very good number on that, because it is offshore to the other entities who are managing this.

But because of that, there have been internal audits that have suggested that maybe it's not as effective and maybe we are adding red tape that is actually costing us money.

You know, one Republican lawmaker told me earlier this week, you know, if we are sitting here wondering about our budget crisis and Medicaid, maybe it's time to reconsider whether we are adding something that is actually costing us more than it's bringing in.

Although selling that politically is going to be a challenge.

And I'm paraphrasing.

Administratively, I mean, the employees that run that program would tell you the power account is administratively very difficult to implement.

Well.

And the fact that we have been using them for so long because of the pandemic.

But, Niki, we're also talking about pretty significantly size population here.

Yeah, it's a huge amount.

I think when we originally put HIP 2.0 in, they thought maybe 350,000, it's up to 750, 60,000 people who are relying on this.

I think the fear that comes and that if I were someone on that program is that Republican, the Republican Supermajorities, they're looking for a way to save money.

And the fear out there is, well, we take this completely voluntary Medicaid expansion that we did, and we just say that that didn't work, and that would be a huge savings to the state.

Yeah.

Though it's hard to take away something you've been giving for, I mean, it's a decade now or so or close to it.

Well, another thing to add is that the federal government pays 90% of this.

You know, we are paying very small amount at this time.

Of course, that will change.

All right.

The U.S. Supreme Court ruled along Partizan lines this week that presidents have near-total immunity from prosecution for official acts and placed a high bar for holding them accountable for private action.

According to the decision, presidents can't be prosecuted for exercising their core constitutional powers.

And even in situations where former presidents might be prosecuted after leaving office, they are entitled to at least presumptive immunity from prosecution for official actions they took as president.

Conservatives hailed the ruling as a victory for former President Donald Trump, and what they view as the politically motivated prosecutions against him.

President Joe Biden said the decision is a dangerous precedent that undermines the rule of law.

Meanwhile, Biden faces more calls to step aside as the Democratic nominee after a disastrous debate performance last week.

Elise Schrock we're going to talk about the Supreme Court ruling, but I want to talk about President Biden first.

Does Joe Biden give Democrats the best chance to keep the white House?

Look, no sitting president by any party has not been nominated by that party.

And I'll also say this.

This is kind of like when I talked to some of my crisis communications clients and I say, do you want me to tell you what you want to hear?

Or do you want me to give you the realistic field of play and the realistic field of play?

Is this.

It is July.

We are four months out from an election.

We are weeks out from a nominating convention.

Joe Biden is going to be the nominee.

Our choices are the guy that incited January 6th, the worm guy and an Uber elder statesman.

Those are our choices.

and with the Uber elder statesman, we get a cabinet that looks like the people it represents, experts in their field.

We get someone who has the opportunity to meet or some balance to a Supreme Court that is wildly conservative.

who with the onset of Donald Trump, I have less rights than I did when, than before his effect, his reign took effect.

and a Supreme Court who has basically told us that they're not scared to roll back other rights.

There is a lot at stake.

And I would love to say to Democrats, there is some West Wing character who can deliver some shit that can put them to bed at night.

They can kiss us on the forehead and tell us that tomorrow we will wake up and everything will be okay, but that's just not how it is.

Our democracy is on the line.

It is tenuous at best.

things are at stake.

And if you want something to be hopeful about, there are so many local, wonderful candidates.

Stop doomscrolling.

Look out in your local, local Democratic party for the candidates that you can write postcards for, that you can volunteer for.

It feels good to do something.

that's an opportunity that there have.

There's so much more than precedent on the ballot.

And, yeah.

So Joe Biden is going to be the nominee, and we have a lot to vote for.

A lot is at stake.

And I think you could ask the same of the Republicans.

Is Donald Trump the best candidate that you could put forward at this time?

yeah.

When Lyndon Johnson announced that he wasn't going to run again, there was lots of time for Democrats to coalesce around who ended up being Hubert Humphrey.

Although, obviously, Hubert Humphrey then lost.

I mean, that in and of itself might be, a sign, but I mean, it is at least right at this point.

Is replacing the nominee just, fantasy Elise, that was a wonderful job of explaining and said it doesn't really matter that he can't put a sentence together.

He's got to be in bed by 8 p.m..

But a higher level.

But a higher level of good to.

The cabinet.

That we can have.

Bernie's that guy all the way through 2028.

That's like the last.

There are, there are there there are practical limitations.

Sure.

And there's a convention process that leads into, you know, ballot certification at the state level and in that process.

But in modern politics, unprecedented or not, we're doing unprecedented stuff every day in American politics right now.

We're we're impeaching everybody.

If both sides are impeached the other side fast enough.

What used to be a tool we never used that we considered sacred and extraordinary.

We're doing that all the time.

I don't think if Joe Biden came out tomorrow and said, I don't have it at me, but here, here's a list.

But I trust my convention to go pick the guy that can and beat Donald Trump for all the reasons you think he needs to be defeated.

I don't think that's an impossibility.

It seems increasingly, I mean, the the noise is getting louder around the idea of replacing Joe Biden, but it also sounds an awful lot to me like only Joe Biden can make that call at this point, right?

Yeah.

And I think that one of the names that's floated up is Kamala Harris.

And I don't think that there is enough consensus that she could be Trump among people who are worried.

And so they think that Biden is their best shot, whether or not they're right.

I don't think we know that yet.

But I just I don't really see a lot of certainty and confidence in people on either side about what exactly.

They're the first party to get rid of their octogenarian candidate is is going to win.

I mean, the polling with like, Nikki Haley, like for for Republicans was extraordinary.

It's like she's walking into the white House, call the election off.

We just can't do it.

Something someone someone pointed something out online that I thought was an interesting way of viewing this decision.

If such a decision has to be made, which is if Kamala Harris is the nominee, the race becomes about Dobbs, it becomes about abortion access, it becomes about Donald Trump.

It becomes about all of the things that you just kind of list it off.

And if Joe Biden is the nominee, the race is about Joe Biden's age.

Is that is that too big a problem to overcome?

I mean, look, I'm not I'm not a strategist, but I would think they are setting themselves up for the entire campaign, just being responding to his ability to do the job, which automatically just makes it nearly impossible to win.

I mean, if your whole focus is my guy, can, you know.

80%?

Yeah.

He thinks he can.

I just while considering the other candidate and the track record.

Yeah.

The other thing that I found interesting following it is we all thought it was a terrible, terrible debate.

But, you know, we had newspapers coming out and saying that Biden should drop off.

I did we have a newspaper come out and say that Trump should drop off when he was a convicted felon.

Now.

The New York Times.

Now.

That publishes the.

Exact.

Speaking of the president, then, the Supreme Court decision as we look ahead to November and right now, if the election were held today, clearly Donald Trump would be elected and that seems I'd put my money on that right now.

Did the Supreme Court just give him a blank check to pretty much do whatever he wants to whomever he wants, whenever he wants, as long as he tries to make it official?

and ironic that it was on the July 4th holiday, which, you know, if you're looking over the years, are we that surprised?

Because it's not even just a king that we were trying to declare independence from, right.

It was a system of peerages where the top amount, the top people, in the peer system held all the money.

Unquestionably.

You know, in the British government, that's what we were also declaring independence from.

And, you know, ruling after ruling has also allowed that to happen.

It's just a lot of irony, but it's also a problem.

I mean, this I don't think that is the type of executive power that the current president wants.

I don't think it's the type of power that, Trump 2.0 should have clearly, and that, again, is what is at stake if we see a second round of his presidency with a Supreme Court like this, that has unchecked power to keep making rulings of this nature.

It I don't understand how in the in the system of conservatism that I've always understood growing up in this country how a conservative supreme Court could say, oh, yeah, the executive should have pretty much unlimited power.

Yeah.

But you're arguing that that president will argue that.

No, that was official.

The thing that I'm being challenged on and on the judicial branch, that was what I did, was official.

They got to still go make that argument right.

It was interesting that both political parties had the exact same message.

Trump has total immunity was what Trump said and what Republicans said and what Democrats said.

obviously for, you know, intending opposite reactions.

but he doesn't have total immunity.

And I do think to some, to the degree of official, I don't know how you could be president and you're the one guy that can order a nuclear strike and you're not immune from being hauled in front a world court at the end of it.

You know, you've got to, but you've for whatever it's whatever the justification for, you know, the acts that you make, especially those that involve declaring war and operating or, so I do think the president should have that immunity, but I don't think, I don't think the Supreme Courts, frankly, I don't think the Supreme Court's decision on this was like all that remarkable.

I think it was like politicized.

But I think, like, the court's still going to have to be able to strike.

Like official and non-official.

Act.

Yeah, but the court still just going to have to decide that.

And whoever the president is just got to sound to make the argument that that was official.

Reading Justice Roberts opinion, though.

Chief Justice Roberts opinion.

No, I mean, he seems to define they didn't draw a hard line on what is official and what is non-official or private, but it felt like they he blew the doors open on official pretty widely.

I mean, talking about like when when members of if members of Trump's Justice Department told him, you lost this election, those conversations are official.

And if he were sued privately over January 6th, you couldn't have those those officials testify of what they talked about because it was an official action and that can't be brought up.

That was also a part of the ruling that can't be brought up in court, even on a private case.

Is that so?

Yes.

I agree that the court is still going to have to call those balls and strikes.

But did the Supreme Court make this a lot broader than I think a lot of people were?

And I think a lot broader than people were expecting.

And I don't think that I think that people had a pretty firm idea of what an official act could and couldn't be.

And then they kind of got a lot murkier and grayer.

and I think that it still remains to be seen.

I'm no constitutional scholar, and I couldn't really tell you what all the minutia of the ruling fallout might be, but I think that that's something that just remains to be seen.

It does feel an awful lot like in the history of this country.

There's maybe one president who wanted who would have wanted to exploit this, which was Richard Nixon.

And to Donald Trump, doesn't it feel like he's the one guy who's going to try to push this ruling as far as it can go?

Well, yeah, he has to because he's facing multiple.

Even if he gets if he gets if he gets back in, I'm saying will he try to push it even.

Further.

Maybe.

I mean, to me, the most frustrating part of the the ruling was that, I don't know, I felt like it was kind of all over the place.

This is okay.

This is we're not going to tell you whether it was okay.

This was not okay.

I mean, they basically just set it up for individual fights over every little thing, and that's frustrating.

I think a lot of people.

Just given a Partizan.

Yeah, I think to go after the.

People really wanted some definitive answers.

And we didn't get that as much as we wanted.

All right.

Time now for viewer feedback.

Each week we put an unscientific online poll question.

This week's question is should Joe Biden step aside as the Democratic nominee for president, a yes or B no?

Last week, we asked you whether conservative Democrat Terry Goodin should be nominated for lieutenant governor by Democratic convention delegates next weekend.

69% of you say yes, 31% say no.

If you'd like to take part in the poll.

Go to wfyi.org/wire and look for the poll.

Libertarian gubernatorial candidate Donald Rainwater has a proposal that could dramatically reduce many people's property tax bills, a plan that involves changing the state constitution.

The current constitution caps homeowners property taxes at 1% of the property's assessed value.

Rainwater is proposal would cap them at 1% of the purchase price.

That could blow big holes in local government budgets, and rainwater says the state needs to reform how locals are funded.

When property taxes and assessments are going through the roof, and citizens are asking the General Assembly.

For.

For help and for relief, the majority of them, their answer is, well, we don't have anything to do with that.

That's a local problem.

And you can quote me, that's a lie.

Rainwater says he would use the governor's office as a platform to pressure lawmakers if they don't follow through with his proposal.

Niki Kelly, does this proposal work, financially speaking?

Look, we have no idea if it does, because and I've been on this kick since Suzanne Crouch and the acts of the tax thing, we have got to stop throwing out proposals that have, you know, millions and billions of dollars worth of impact without saying what that impact is like, how much money would be lost by changing that to 1%?

It would be astronomical.

And to just be like, oh, local governments can tighten their belt.

Well, to be fair, he his point was local governments not so much tightening their belts as the state government backfilling what they would have gotten.

But then of course, that blows a huge hole in the state government.

Exactly.

And so we just need to be more upfront with people.

If you want this tax reduced, you're going to have to give up some services and I'm just tired of playing the game of here's my catchy phrase.

Or doesn't it sound great to cut everyone's property taxes when we're not discussing the other end of it?

I want to talk more broadly about the idea of changing the state's property tax system a little bit because increasingly, you know, the state lawmakers have had this two year now study committee on on the entire tax system.

And it started out with Senate Republicans wanting to get rid of the income tax and kind of everybody starting to go, oh, maybe that's not a great idea.

And it seems like people and, you know, we saw it from the Republican gubernatorial candidates.

People are talking about property taxes more than anything else.

Is that going to be what lawmakers have to key?

You know.

And I want to kind of preface that, you know, rainwater and any other property tax proposal would really need to consider renters because they're, you know, are a fair, significant amount of renters in the state.

And, you know, those landlords are not always passing those savings on.

but but with property taxes, it is just such a complicated system.

You can't just make one tiny little lever and flip it and make it easier for everybody.

Every time the General Assembly tries to tackle property taxes, it ends up being a, you know, 50 page bill minimum.

And yeah, I mean, politically, you know, going back to the earlier conversation, the political difficulty to some this would be very easy politically to do.

Hey, let's glitz lower property taxes.

But I mean the mechanics of that are almost impossible.

Well, I mean for a certain population, I mean, there is a lot of sympathy.

There's all sorts of the for me, at 45, owning a home that's going to increase in value for the next 40 years.

I'm going to I'm going to realize that gain at some point.

I'm still working, but people that aren't working to own their home for, you know, or to retire, that they own their home and now they've they've got this asset that's probably going to be liquidated and death.

And, but they've got this bill sitting there and they don't have the money to pay it because they, they own their home.

And, but it's great that the value went way up.

Yeah.

The value spiked because, you know, just housing values are outpacing, you know, easily outpacing even this inflation or inflation the last two years.

We've got to figure out some solution for probably the most sympathetic group.

Yeah.

We've seen some legislation on that topic is if, if we do anything to the property tax system is something for folks on a fixed income.

Seem like the most likely scenario.

I think probably I mean.

I think yes, and it's going to be something that will also affect the Constitution.

Which.

Right.

Which I mean, that's going to take several sessions like general sessions.

So before we even see any impact for this, it will be, you know, right.

At least two general sessions.

So four years and a referendum.

So yeah, maybe 4 or 5 years.

So they would have to start on it right away.

Yeah Dan Leonard vindicated.

He didn't want to put those caps in the Constitution.

All of I mean as part of the problem here too, that whatever lawmakers do to property taxes, it's not the state but a balance sheet that that gets a Fotolia.

And and obviously the state lawmakers were interested in what we can do because we're getting they've got extra money on the state side once they go to homeowners though and property taxes, it's not their budget, but they also have to be cognizant that, you know, you can't gut schools and you can't stop firefighters from coming to someone's house.

This the state has been flush with cash for a while, not so much local governments.

All right.

That's Indiana Week in review for this week.

Our panel is Democrat Elise Schrock, Republican Mike O'Brien, Whitney Downer of the Indiana Capital Chronicle, and Niki Kelly of the Indiana Capital Chronicle.

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 opinions expressed are solely those of the panelist.

Indiana Week in Review is a WFYI production in association with Indiana's public broadcasting stations.