U.S. Sen. Mike Braun — the Republican nominee for Indiana governor — made a surprise appearance at the National Healthcare Price Transparency Conference Monday, earning recognition for his work on health care price transparency on the federal level.
Conference emcee Gloria Sachdev, the president and CEO of Employers’ Forum of Indiana, presented both Braun and fellow U.S. Sen. Bernie Sanders of Vermont with an award recognizing them as “Champions of Healthcare Price Transparency.” The two, at opposite ends of the political spectrum, worked together on a measure to tackle transparency for hospital and insurer pricing. Gloria Sachdev, the president and CEO of the Employers’ Forum of Indiana, presents the Sage Transparency 2.0 project at a conference on May 13, 2024. (Whitney Downard/Indiana Capital Chronicle)
“This is reforming the system, not more government spending on it,” Braun said. “I’ll keep pushing hard for the five months or so that I’ve got left (in Congress). Hopefully we‘ll see that maybe cascade further. If not — and if I’m successful in November(‘s general election) — I’m going to be the most entrepreneurial governor the country’s ever seen on fixing health care.”
Braun’s appearance coincided with the release of the latest hospital prices study by the RAND Corp., a think tank, which found Indiana’s hospital prices were 8th-highest in the nation. Also on Monday, the Employers’ Forum of Indiana launched Sage Transparency 2.0, a dashboard providing cost breakdowns and revenue information for hospitals.
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The Indianapolis conference drew nearly 200 in-person attendees and dozens more online, with speakers like entrepreneur and venture capitalist Mark Cuban, national accountant experts, state legislators and patient advocates. The forum, which hosts the conference, seeks to improve health care transparency, prices and quality with an emphasis on the value for employers.
Indiana’s hospital lobbying organization continued to push back against the RAND analysis, pointing to its own data on thin — or even negative — hospital margins and saying the study’s data provided a “distorted” view of prices in Indiana.
“We’ve been rather consistent (with criticism) about the RAND reports in that they are presented, I think, without the proper context and usually with an agenda,” Indiana Hospital Association President Brian Tabor told the Capital Chronicle. “When you look at the totality of what employers spend for medical services and health care services with our hospitals and health systems, you have to take into account that we have massive subsidies and financial losses associated with providing physicians.”
Tabor said the study didn’t include the entirety of spending on hospital and health system services, which would actually put Indiana in the middle of states in terms of costs nationwide.
He also said Monday’s presentations “(beat) up on hospitals, particularly health systems,” without providing solutions or acknowledging the full context of Indiana’s low Medicaid reimbursement rates.
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Price data and information
The biggest takeaway from the RAND study was that employers paid, on average, two-and-a-half times more than Medicare prices — a federally set number that is supposed to be close to a “breakeven” number for providers giving care.
But Chris Whaley, one of the RAND researchers and a professor at Brown University, noted that there is a lot of variation between states and within states but Indiana’s prices still ranked high even when compared with its neighbors. For example, Michigan’s prices compared to Medicare hovered below 200% while Indiana was closer to 300%, on average.
“(We) collectively spend about $1.5 trillion on health care, with the largest chunk of the pie — half a trillion dollars — going towards hospitals,” Whaley said. “… hospital care, over the last few decades, has increased … by over 200%.” RAND researcher and Brown University professor Chris Whaley presents his findings a transparency conference on May 13, 2024. (Whitney Downard/Indiana Capital Chronicle)
Whaley said the purpose of the study was to give employers information on prices negotiated on their behalf. The analysis then compares prices at more than 4,000 hospitals and 4,000 ambulatory surgical centers with Medicare.
“Without both price transparency and market competition, it’s not possible to have an efficient market-based health care system. And so, if we’re going to keep relying on markets in the United States for health care, we need to have both greater transparency and improved market competition,” Whaley said.
The key driver to prices appeared to be the percentage of market share a hospital system had in its area, not its quality or payer mix. That means hospitals with high low-income populations on government insurance programs fared no better or worse than their counterparts.
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The lack of market competition is a problem in nearly every corner of the country, according to Whaley’s analysis, and state legislators have been interested in exploring the impacts of monopolies on Indiana’s markets.
Braun said that “sooner or later the (Federal Trade Commission) will get involved” when it comes to monopolies, stressing that he “(doesn’t) want the government meddling in anything other than keeping the markets competitive and fair.”
“… It’ll come apart,” Braun told attendees. “I’ve told CEOs of drug companies and hospitals, ‘You better start embracing (pushes for reform) or otherwise Bernie Sanders will run your business someday.”
Hospitals, however, say they’re struggling.
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Indiana hospital prices named fourth-most transparent
A recent analysis from Kaufman Hall promoted by the hospital association found that Indiana’s hospitals had just a 1% operating margin in 2023, compared to national margins of 2.3%. Indiana hospital profits grew more sluggishly than their peers while expenses grew faster.
That directly contradicts what another Monday presentation from the National Academy for State Health Policy (NASHP) found. Its presentation, with a focus on its Hospital Cost Tool, found that Indiana’s hospitals had higher median net profits than the national average.
Tabor said that presentation relied on information from Medicare cost reports, rather than audited financial data. But presenter Marilyn Bartlett with NASHP said the audited financial statements don’t provide the same breakdown for each hospital like Medicare cost reports do.
Kaufman’s analysis, on the other hand, uses audited financial data for the entire health care entity but not its investments — the same information bond markets use — according to Tabor.
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“We’re increasingly seeing it’s difficult just to maintain access, even in our growing parts of the state. Hospitals have to pay for those services at what comes to large financial losses. So you have to combine the losses int hose physician practices, which are separate organizations — not on the cost reports … (to) look at the total financial picture,” Tabor said.
The importance of transparency
Price transparency directly benefits patients and — by extension — employers, said Cynthia Fisher, who founded patientsrightsadvocate.org. Fisher detailed individual experiences of people trying to navigate the complexities of medical billing and ways her organization tried to support patients and intervene on their behalf.
“Ninety-four percent of Americans want to know prices upfront. They want financial certainty and they do not want to be surprised by medical bills that they can never afford,” Fisher said. “Nor do employers want to be surprised.”
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One woman received a quote for a hysterectomy at $5,000, only to see a $74,000 bill that her insurance denied to pay, Fisher said. The hospital eventually placed a lien on her house during payment negotiations. Cynthia Fisher, founder and chairman of Patients Rights Advocate, talks about the importance of transparency at a May 13, 2024 conference. (Whitney Downard/Indiana Capital Chronicle)
“She came to us with a financial … fear of losing her home,” Fisher said.
Her organization’s intervention and review of the hospital’s pricing file found that the bill should have been closer to $8,000, but the process took more than four months.
“She proved it by having access to the actual prices. And what did she learn from that? Estimates don’t work,” Fisher said.
While there has been national momentum to provide price transparency, Fisher said such standards are unevenly applied across the country. In states like Indiana, just over half of hospitals conform to such requirements compared to the one-third of hospitals nationwide posting prices publicly.
“What we’re finding is that (U.S.) Health and Human Services and the federal government has been really slow to truly enforce this law and so we have seen only 14 hospitals been fined,” Fisher said.
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Tabor pushed back on this assessment, saying that the methodology was “subjective” and others had found nationwide compliance to be much higher — closer to 80%.
Price transparency efforts have spanned across three presidential administrations, most recently with President Joe Biden increasing fines to $2 million. Fisher said just two hospitals have been hit with those fines.
The lack of transparency has likewise influenced prices in drug markets, said Cuban, who co-founded Cost Plus Drug Company. The firm directly sells generic medications to consumers and has roughly 2,500 ones listed. It recently expanded to manufacture its own generic drugs.
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Cuban compared his site, which shows a company markup of 15% alongside a $3 pharmacy handling fee and $5 shipping fee, with traditional pharmacy systems that often must negotiate prices with Pharmacy Benefit Managers or Third Party Administrators.
He pushed the employers present to be proactive in accessing their claims data held by insurers or other contracting parties, something Indiana recently formalized in a 2024 law that requires such partners to allow access and regular audits.
“The missing ingredient in health care isn’t the quality of health care, it’s trust. Other than your doctor, nobody trusts anyone,” Cuban said, urging employers to extensively negotiate their outside health care contracts. “… the future of health care in the United States is in your hands.”
INDIANAPOLIS — Central Indiana is settling into a stretch of late-November cold that will linger through the Thanksgiving holiday and set the stage for a potentially accumulating snowfall this weekend, according to the National Weather Service.
A strong high-pressure system advancing out of Canada will settle over the region through the rest of the week, bringing below-normal temperatures and brisk winds.
“It’s certainly a late-November, early-December cold pattern,” NWS meteorologist Alex McGinnis said. “We’ve got big high pressure coming out of Canada that’ll be slowly moving into the area through the rest of the week.”
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Wind chills were in the teens across much of the area early Thursday and are expected to remain in the 20s during the afternoon, even as temperatures climb just above freezing.
“It will definitely be a chilly but dry Thanksgiving Day,” McGinnis said. “Winds will be dying down tonight, but we’ll still have a bit of a breeze with lows down in the teens in places like Rockville and Frankfort. It will be a cold night across Central Indiana.”
Friday is expected to remain cold, with highs near freezing.
Thanksgiving’s conditions follow a blustery Wednesday that brought sustained winds of around 15 mph and gusts reaching 25 to 30 mph in northern counties.
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“Even though temperatures will be a little above freezing this afternoon, you’ll want to keep your skin covered and dress in multiple layers if you’re outside for any longer period of time,” McGinnis said.
Forecasters are increasingly confident a storm system will bring snow to the region Saturday into Saturday night.
“There’s a possibility for light to moderate snowfall accumulation in the Saturday to Saturday night timeframe,” McGinnis said. “Chances for more significant snowfall are greater north and west of Indianapolis. That includes areas north of I-70 like Crawfordsville, Lafayette and Kokomo, especially Saturday afternoon and evening.”
Light snow is also possible in southern counties including Vincennes, Bedford and Seymour. Some areas may see snow mix with or change to rain Saturday night.
“It’s not quite cold enough for a wind chill advisory, although wind chills will get into the single digits tonight and early Friday across northern Indiana,” McGinnis said. “We’ll have to see whether any updates or expansions of the winter storm watch are needed later today.”
POV: At Indiana Statehouse Org Day as House keeps redistricting alive
It was a busy ceremonial first day of the 2026 legislative session as redistricting and other major topics took center stage.
Though the Indiana House plans to reconvene to talk about redistricting on Dec. 1, there are two things that could get in the way: making quorum, and overcoming the fact that Republican leaders appear to have broken a House rule.
Per House rules, Republican legislative leaders should have gotten approval from House leadership in order to convene in December. Democrats say they never signed off on the change, but House leaders maintain they’re still following state law.
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Either way, the House needs a two-thirds vote to meet in order to take up redistricting. If all Democrats are on the same page in their opposition, and with just 70 Republicans in the House, only five could break from the party, and the House would not be able to move forward with redistricting in December.
Should either of these things happen, it would only be the latest whiplash Indiana has experienced with regard to President Donald Trump’s request to redraw the state congressional map mid-decade, in order to give Republicans more favored seats before the 2026 midterm elections.
How we got here
State leaders held out for months, even with two visits from Vice President JD Vance and a mounting pressure campaign from the White House. Then Gov. Mike Braun called for a special session to redistrict in October, even though Senate President Rodric Bray insisted his chamber didn’t have the votes to make it successful. But the two legislative leaders came up with a date anyway: They would convene during the first two weeks of December for redistricting.
Then on Nov. 14, Bray reversed course and said the Senate would not show up since the votes weren’t there. This seemed to solidify on Organization Day Nov. 18, which kicked off the 2026 legislative session. Both the House and Senate chambers agreed to a concurrent resolution that set their return date on Jan. 5.
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House Speaker Todd Huston, in a harbinger of what was to come, nonetheless told his members to keep their December calendars open.
On Nov. 25, he formally announced his chamber would be convening Dec. 1. Minutes later, Bray again switched up and said his chamber, too, would convene and a week later and vote on whatever map the House sends over.
Why lawmakers aren’t following the House’s rules
Therein lies the rule issue. The time and date that the House reconvenes can be changed from what was in that concurrent resolution from Organization Day, but only “with the agreement of the Speaker and minority leader,” the House standing rules say. House minority leader Phil GiaQuinta, D-Fort Wayne, said there was no such agreement, and it’s his position that the House should reconvene on Jan. 5 as written.
“The speaker called me this morning and said we will be going in Dec. 1,” he said on Nov. 25. “I did not agree to that.”
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Even if lawmakers aren’t following their rules, they would be following state law by meeting on a different date than planned as long as enough lawmakers are present. A spokesperson for Huston pointed to the provision in state law that enables lawmakers to meet “either on a certain day fixed by concurrent resolution or when the gavel of each house falls in the presence of a quorum.”
It’s also not unusual to suspend House rules, but it too can only be done with a two-thirds vote.
Huston has said his chamber has the votes to pass a redistricting measure, but that’s because they just need a simple majority, or 51 members. Establishing quorum and suspending rules is a higher bar.
A House Democrat is focusing on the quorum issue in particular, calling out five Republicans by name and urging them to deny quorum on Dec. 1.
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“I’m just saying, for the period of time where there’s a quorum call, people may be busy,” said Rep. Mitch Gore, D-Indianapolis. “I’ll pick listening to the people and showing some backbone over allowing my constituents to get ripped off by a 9-0 gerrymander.”
The five Republicans Gore is publicly naming are Reps. Becky Cash, R-Zionsville, Dave Hall, R-Norman, Danny Lopez, R-Carmel, Hunter Smith, R-Zionsville, and Ed Clere, R-New Albany.
Clere, Lopez and Cash have stated publicly or on social media that they are opposed to redistricting. Hall and Smith have not made clear their positions.
“If they really oppose redistricting, it’s up to them to deny a quorum,” Gore said.
But Clere sees it a different way, saying in a statement to IndyStar that a walkout is not the answer to stopping redistricting because “it’s not constructive.”
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“Mid-cycle redistricting is harmful to both the legislative institution and to democracy more broadly,” he said. “A walkout would only deepen the existing partisan divide and further undermine the legislative institution.”
Likewise, Lopez and Cash said they will be there on Dec. 1.
Through spokespeople, the other Republican representatives did not respond to requests for comment.
The pressure has been intense around the redistricting debate. Voters in certain districts have been targeted with texts and calls from various nonprofits supporting redistricting. And some of the pressure has turned dark: At least seven state senators have received some kind of violent threat since Organization Day, including some incidents of swatting, which is when a person calls in a false tip that prompts a large law enforcement response. Even Braun has received “credible threats,” his office said.
There’s also the threat of primary challenges against lawmakers who vote against redistricting. Trump has openly called for this; at least one such challenger has already emerged in Republican state Sen. Spencer Deery’s West Lafayette district.
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This story may be updated.
Contact IndyStar Statehouse reporter Kayla Dwyer at kdwyer@indystar.com or follow her on X @kayla_dwyer17.
No. 1 Ohio State and No. 2 Indiana are closing in on a historic matchup in Indianapolis.
If the Buckeyes and Hoosiers win this week against rivals Michigan and Purdue — and in Ohio State’s case that’s been a big if lately — they’d both bring undefeated overall records into the Big Ten title game. That’s never happened since the conference began playing a championship game in 2011.
In fact, only three times since Michigan State’s arrival pushed the league to 10 teams in 1953 has the Big Ten finished its regular season with more than one unbeaten team in league play. In 2013, Michigan State won the Legends Division at 8-0, and Ohio State won the Leaders Division with the same record. The Spartans beat the Buckeyes in the title game — but even that year, Michigan State had taken an early loss outside the Big Ten to Notre Dame.
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In 2002, Ohio State and Iowa both went 8-0 in league play. The Buckeyes went to — and won — the BCS championship game, and Iowa headed to the Orange Bowl.
The situation was far more acrimonious in 1973, when Michigan and Ohio State played to a tie, and each finished the conference season 7-0-1 — and 10-0-1 overall. Athletic directors voted to send the Buckeyes to the Rose Bowl.
According to Sportradar, only one FBS conference championship game has ever pitted two teams with unbeaten overall records. Alabama beat Florida 32-13 to win the Southeastern Conference in 2009. Of course, that year the losing team was finished as a national title contender because there was no playoff yet.
The stakes will be lower if Ohio State (11-0, 8-0, No. 1 CFP) and Indiana (11-0, 8-0, No. 2 CFP) make it to Indy with unblemished records, but it would still be quite a finish to the Big Ten season.
Star power
An Ohio State-Indiana title game could also become a de facto Heisman Trophy decider between Buckeyes quarterback Julian Sayin and Hoosiers QB Fernando Mendoza. Notre Dame running back Jeremiyah Love is also a contender, but his final pitch is this week because the Irish aren’t in a conference and thus won’t be in a title game.
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Going bowling
Ohio State, Indiana, No. 5 Oregon (10-1, 7-1), No. 15 Michigan (9-2, 7-1), No. 19 Southern California (8-3, 6-2), Washington (8-3, 5-3), Iowa (7-4, 5-3), Illinois (7-4, 4-4), Nebraska (7-4, 4-4), Minnesota (6-5, 4-4) and Northwestern (6-5, 4-4) have reached the six-win mark for bowl eligibility. The winner of the game between Penn State (5-6, 2-6) and Rutgers (5-6, 2-6) joins them.
Hot seats
As seems to be the trend nowadays, a lot of these situations were resolved before the end of the regular season. Penn State fired coach James Franklin in the middle of October, for example.
Also, Wisconsin has already said it is keeping Luke Fickell, and Maryland is standing behind Mike Locksley.
The big remaining question is whether Jonathan Smith can survive a second straight bad season to start his tenure at Michigan State.
Youth movement
Michigan’s Bryce Underwood and Maryland’s Malik Washington have been starting at quarterback as freshmen all season. Washington has had to throw more, but Underwood’s most important game is still in front of him.
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Ohio State freshman Bo Jackson has rushed for 835 yards in 10 games.
Recruiting watch
Oregon, not Ohio State, has the Big Ten’s top-ranked 2026 class according to 247 Sports. The Ducks are ranked No. 5 nationally, with the Buckeyes at No. 6 and Michigan at No. 11. Washington is No. 15.
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