Indiana

HIP faces deep cuts as Republicans hide behind Medicaid’s complexity | Opinion

Published

12 months ago

March 10, 2025

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HIP faces deep cuts as Republicans hide behind Medicaid’s complexity | Opinion

The logic is simple: If you can’t win on policy or public support, you try to win with semantics and confusion.

Jay Chaudhary
| Opinion Contributor

Even by government standards, Medicaid is notoriously complex — an intricate web of carve-outs, cross-subsidies, and shared state-federal financial responsibilities. I once heard the funding structure of a particular Indiana Medicaid program described as “a house of cards built on top of a shell game,” which feels like a fair description of Medicaid as a whole.

At the same time, Medicaid — especially Medicaid expansion under the Affordable Care Act (commonly known as Obamacare) — is widely popular. This puts conservatives seeking to cut the program in a bind: They must find a way to undermine it without directly attacking something voters support. The program’s bureaucratic complexity provides that opening.

President Trump and congressional Republicans have ruled out major structural changes to Medicaid, instead focusing on cutting more arcane and opaque features of the program, such as eliminating states’ ability to use provider taxes.

Provider taxes are levies imposed by states on health care providers to help cover Medicaid expansion costs. They are critical to funding Medicaid expansion in many states, including Indiana. The ability to impose these taxes is essential for maintaining state support of Medicaid expansion. To justify eliminating these arrangements, opponents have labeled them as waste, fraud or abuse, using loaded phrases like “money laundering” or “bribery.”

It is fair to critique provider taxes as bad public policy, that they are overly complex and/or create significant disincentives for fiscal restraint. However, these mechanisms are a legitimate exercise of state taxation power on actual commerce within state borders, not a nefarious backroom scheme to defraud taxpayers.

This push to end provider taxes is a prime example of using bureaucratic complexity as a smokescreen for deep cuts to the program. By framing it as a technical adjustment that merely enhances efficiency, rather than a direct funding reduction, Congress can obscure the real impact: jeopardizing Medicaid expansion and restricting access to care for millions of Americans.

The logic is simple: If you can’t win on policy or public support, you try to win with semantics and confusion.

Healthy Indiana Plan could reduce care for hundreds of thousands

Indiana’s version of the provider tax, the Hospital Assessment Fee, plays a crucial role in funding Medicaid by generating federal matching funds. This money is essential for maintaining hospital reimbursement rates and supporting the Healthy Indiana Plan, the state’s Medicaid expansion program under Obamacare. The HAF allows Indiana to sustain and expand access to care without relying entirely on state general fund dollars.

The HAF generates over $1 billion annually, bringing in additional federal money that hospitals rely on to care for Medicaid patients. With state lawmakers already concerned about rising Medicaid costs, finding an additional $1 billion to sustain HIP could be an insurmountable challenge.

Eliminating the provider tax may sound like a mild technocratic tweak, but in reality, it would gut Medicaid expansion, destabilize hospital finances, and reduce access to care for hundreds of thousands of Hoosiers. By branding these changes as a crackdown on “waste,” politicians can claim to be protecting taxpayers while sidestepping responsibility for the millions who could lose health care access.

A major threat to addiction services

Over the past decade, Indiana has significantly expanded access to addiction treatment, including residential care, medication-assisted treatment and peer support, leading to one of the largest drops in overdose deaths nationwide.

The heroic Hoosier recovery community deserves the most credit for these wins, and HIP is the policy and programmatic foundation that makes it possible. Traditional Medicaid primarily covers the aged, blind, and disabled. Medicaid expansion programs (like HIP) extend coverage to a broader low-income population.

Most individuals with substance use disorder are both low-income and not classified as disabled, meaning they would have no access to care without Medicaid expansion. The elimination of the HAF — and the likely cuts to HIP that would follow — would reverse Indiana’s progress, severely undermining our fight against addiction.

It is reasonable to argue that addressing the national debt may require difficult choices, including potential limits on Medicaid spending (although that argument is severely undermined when accompanied by a deficit-exploding tax cut).

Likewise, a philosophical debate about the government’s role in health care or Medicaid expansion’s mixed track record on health outcomes is a legitimate discussion. But, if lawmakers want to debate Medicaid expansion, they should do so transparently, without disguising significant cuts as routine and harmless policy adjustments.

Jay Chaudhary is the former director of the Indiana Division of Mental Health and Addiction and former chair of the Indiana Behavioral Health Commission.

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Indiana

Indiana’s Curt Cignetti cashes in on title run with 8-year extension worth $13.2 million per year

Published

42 minutes ago

March 2, 2026

Press Room

Indiana’s Curt Cignetti cashes in on title run with 8-year extension worth .2 million per year

Indiana coach Curt Cignetti is cashing in on his first national championship run — even more than initially expected.

Athletic department officials announced Monday that the two-time national coach of the year has signed a memorandum of understanding on an eight-year contract extension, paying him an annual average of $13.2 million — or an increase of about $1.6 million per year from what school officials said Cignetti would earn when he first agreed to the extension in October.

School officials released the document Cignetti signed Feb. 4.

He joins Georgia coach Kirby Smart and LSU coach Lane Kiffin as the only active Football Bowl Subdivision coaches to receive paychecks of $13 million or more. The payouts could be even higher if Cignetti earns bonuses for winning Big Ten or national coach of the year honors in addition to playoff appearances and conference titles. The 64-year-old Cignetti already has said he hopes to retire at Indiana.

The new deal calls for a base salary of $500,000 per year through the 2033 season and a $1 million retention bonus on Nov. 30 of each year, starting this fall. The remaining portion of the $105.6 million will be collected from outside, promotional and marketing income.

Cignetti initially agreed to an eight-year extension worth $92.8 million — an annual average of $11.6 million — but university officials agreed to modify the deal as the Hoosiers remained undefeated and pursued the first football national championship in school history.

It’s the third time Cignetti has received a raise since he took over the losingest program in FBS history in November 2024. All he’s done since arriving is produce the two best seasons in school history while becoming one of college football’s fan favorites for his quick quips and unique facial expressions. Players have embraced him, too, telling many of their favorite Cignetti tales.

Just ask tight end Riley Nowakowski, who recounted his favorite Cignetti story during the recent NFL scouting combine in Indianapolis.

“I think (Alberto Mendoza) was in the game, and he pulled like four runs in a row,” Nowakowski said, referring to last season’s victory over Illinois. “He kept pulling it, kept pulling it, kept pulling it, and then after the fourth time, it was a terrible read. So in the middle of the game, (Cignetti) tells our coach, ‘Get (Alberto) over here.’ Bert’s like, ‘What, it’s the middle of a game, what are you doing?’ And (Cignetti) goes, ‘We’re not paying you to run the ball, hand the ball off, right? We’re up like 70 points, but he’s pissed off, yelling at Bert, and (Cignetti) just turned back at me and gave me one of his little smiles, and he was just like, ’You like that now?’”

Cignetti wasted no time delivering on his promise to win after leading James Madison to the most successful transition from the Football Championship Subdivision to the FBS.

The son of Hall of Fame coach Frank Cignetti and a former Alabama assistant led Indiana to a school record 11 wins and its first College Football Playoff appearance in his first season with the Hoosiers.

Last season, he outdid that mark by producing the first 16-0 mark in major college football since the 1890s. The Hoosiers also won their first outright Big Ten crown since 1945, beat Miami on its home field to claim the national title and shed the label of having the most all-time losses in FBS history.

Mendoza’s older brother, Fernando, also became the first Indiana player to win the Heisman Trophy and is expected to be the No. 1 overall pick in April’s NFL draft.

The reward: A record nine players, including Mendoza and Nowakowski, attended the recent combine in Indianapolis while Cignetti got another pay raise and school officials continued to invest heavily in keeping the coach’s staff together.

Offensive coordinator Mike Shanahan and defensive coordinator Bryant Haines each agreed to three-year contract extensions worth about $3 million per year in December, making them two of the highest-paid assistants in the FBS. Haines won this year’s Broyles Award, which goes to the nation’s top assistant coach.

Indiana will begin next season with the longest winning streak (16) and longest home winning streak (15) in the FBS. Cignetti has never lost a home game with the Hoosiers, who open defense of their league and national titles at home against North Texas on Sept. 5.

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What Tom Izzo said after Michigan State’s win over Indiana

Published

13 hours ago

March 2, 2026

Press Room

What Tom Izzo said after Michigan State’s win over Indiana

Michigan State basketball went into Assembly Hall on Sunday afternoon and controlled the Hoosiers from start to finish, earning a 77-64 victory. The win goes a long way in almost virtually confirming that the Spartans will have a triple-bye in the Big Ten Tournament, while also bolstering the Spartans case to get a No. 2 seed in the NCAA Tournament.

For the second straight outing in the state of Indiana, MSU head coach Tom Izzo came away pleased with his group, and expressed that to the media:

“Well, to be honest with you, for once, we got off to a good start. We haven’t been doing that. We decided to try to go inside, Kohler (had) been struggling, we thought we’d try to get him going. We get that 10-point lead and it kind of stayed that way.
“We did not do a great job of building on it, it’s because they’re a good team. Everybody asks me, ‘Are they good enough to be in the tournament?’ Read my lips: hell yes. It’s just that somebody’s got to lose some of these games. The league is so good.”
“I’m proud of my guys, because coming back from that Thursday-Sunday deal, both on the road, I thought they showed a lot of character. I’m proud of my staff, those preps are not easy at this time of year. Kur came off the bench and really sparked us after making more than a few mistakes.”
“What I appreciated about the game is I thought Jeremy took over. Everything we asked him to run early, to go into Jaxon, he did a great job of. I thought Kur, who’s a sophomore now, took a big step forward after not playing very well the 5 minutes he was in there early and falling down and giving up 3s, and then he bounced back. That’s kind of what you’ve gotta do.”
“We did it a little different way. We said this will be kind of like the NCAA Tournament where you’ve got a one- or two-day prep, one-day prep, so I think it was good for us. I’m really proud of them, but I don’t want to be proud of them until I’m done playing.”
“All in all, guys, we’re in spring break, which means you can practice like 100 times, and nobody arrests you or anything. But our guys deserve some time off and we’ll get some things done tomorrow. “

Contact/Follow us @The SpartansWire on X (formerly Twitter) and like our page on Facebook to follow ongoing coverage of Michigan State news, notes and opinion. You can also follow Cory Linsner on X @Rex_Linzy

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Indiana

Coast Guard investigates death of mariner working barge in Jeffersonville

Published

1 day ago

March 1, 2026

Press Room

Coast Guard investigates death of mariner working barge in Jeffersonville

U.S. Coast Guard officials are investigating March 1 after a mariner died while working on a barge in Jeffersonville, Indiana.

An incident involving the mariner occurred the afternoon of Feb. 27 at mile marker 597 of the Ohio River, said Lt. Cmdr. Steve Leighty, public affairs officer for the U.S. Coast Guard Ohio Valley Sector. Leighty declined to provide further details about the mariner and the circumstances of their death, citing the ongoing investigation.

Officials with the Clark County Sheriff’s Office are also investigating the incident, Leighty said.

Reach reporter Leo Bertucci at lbertucci@usatodayco.com or @leober2chee on X, formerly known as Twitter

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