I think the consensus is in and nine out of ten internets agree that Republican governor Mike Pence of Indiana had quite a week last week. For one thing, his mom told the Terre Haute Tribune Star that her son shouldn’t run for president until he completed two terms as governor. Another thing was that he tried to start a state-run news outlet, complete with a starter staff, managing editor, plans to have evergreen stories and provide exclusives to newspapers around the state, and the fancy title of Just IN. Then, after the Internet essentially exploded, the governor had to explain both that the whole state-run media thing was “an understandable misunderstanding” and that he didn’t even know about it until he read about it in the paper (it not being a Just IN exclusive, I guess). At which point, the governor tried to have a big celebration to announce that roughly 350,000 Hoosiers would finally have access to health insurance after his administration and the Obama administration had reached agreement on the HIP 2.0 version of the Medicaid expansion that had been under negotiation for months. Of course, that news was difficult to see because Just IN was the bad idea that just would not go away. Or at least not until late in the week when the Indiana General Assembly discussed eliminating funding that would go to the fledgling press/news/but not like North Korea news, really, news thing and Governor Pence reassigned the staff members to other areas of the administration and said there would be no such thing as Just IN because it was Just Out. As the kicker, over the weekend, Pence’s fellow Midwest Republican Governor Who Might, Scott Walker of Wisconsin quietly topped a Bloomberg/Des Moines Register poll for the 2016 GOP presidential nomination. And Pence went from a name quietly being talked about as an executive prospect to being loudly excoriated nationally for having a politically catastrophic week, and doing so in such a spectacular way that no one will be whispering about a 2016 spoiler from Indiana anymore. Just ask Governor Pence’s mom.
Now, the expansion of the Healthy Indiana Plan (HIP 2.0) is a genuine triumph for the governor. Under the ACA, Indiana had the option to expand Medicaid to all those whose incomes were too low to qualify for the federal subsidies to purchase individual plans but too high to qualify for pre-ACA, traditional Medicaid. Governor Pence and his administration, however, wanted desperately to deny that expansion (and the ACA overall, which Pence is still saying he believes should be repealed), but accept the federal money that came with it, all while claiming credit for covering thousands of Hoosiers who didn’t have health insurance before. And after months of wrangling with the federal government over how to accept Medicaid without it actually being Medicaid, the federal government finally agreed to let Governor Pence have his cake and eat it, too. So the approximately 350,000 Indiana residents who could have had coverage beginning January 1, 2014 will at last be eligible to pay co-pays of as little as one dollar, sign up, and have coverage beginning more than a year after they could have had it, had the need to make political points not triumphed over good sense. This should have been a good week for the governor, then, and for Indiana’s uninsured residents (pay no attention to the year 2014 behind the curtain). The governor was able to claim a victory, give a speech at a hospital, and call out a real-live soon-to-be-HIP-insured person, who hugged him and said to him and the paper (but not Just IN) that he just didn’t know how much this meant to her and her family, this whole part where they could see a doctor now.
The state’s traditional media outlets published the news on HIP 2.0 as though it were a victory and even some Democrats were saying “this is a good thing” because of the expanded coverage and all that. Of course, they also pointed out that with the whole Just IN thing, the public didn’t really notice and no one could properly pay attention, what with all the fake memes of Pence’s head against the flag of the USSR, China, and North Korea, which were admittedly flashy, but hey, look, health care! Mysteriously, there was little attention paid to the entire year of coverage people did not have when they could have; no questions or trending topics about the cancers which went undiagnosed and advanced a stage in that year, no tweets and no vines about the chronic conditions which went untreated, the prescriptions not taken, the emergency room visits not paid for, the emergency room visits which could have been avoided if people had only been able to see a family doctor; the lost hours of productivity, health, and happiness or the worry that could have been avoided. Potentially 350,000 Hoosiers will have health coverage now, as soon as they can thread the bureaucratic needles, sign up, and qualify. But, in all the hullabaloo with the Great Understandable Misunderstanding, few people bothered to point out that this could easily have been something Hoosiers could already have had for an entire year. This Just IN: it was more important to make a political point regarding HSAs and co-pays and make people’s hard lives harder. It was more important to go for the win, and even if it was obscured by Mao, Stalin, and “Pravda on the Plains,” well, the governor got it.
But if the health care which people could have had last year but didn’t isn’t troubling, we can at least agree that several aspects of the Pence administration’s now-defunct Just IN program are. For one thing, if Mike Pence is to be taken at his word, then how did he not know about a program that already had paid employees and the words “state-run media” attached? If the governor did not know about a program like this until he “read about it in the paper,” what does that say about how his administration is running? What does that say about his administration’s understanding of, say, bullet points? How can that even happen? And when it does, the buck is with Governor Pence. Who is running the show in his office? How does the show get to the paid-staff phase or the media-leak phase without getting to the all-important Pence Awareness Phase? Where was the red flag and what happened that Pence was too disconnected from the standard bearers to see it?
More troublingly still is the fact that Just IN happened in January of 2015. Of all the possible issues and challenges confronting “the state that works,” it would appear that one of the governor’s (or his staff’s) first priorities for Indiana in 2015 was to create a news outlet, no, wait, make that public relations arm, either with or without the governor’s blessing or knowledge. One would think that Indiana had gleaming schools untroubled by rifts between the state Board of Education and the Superintendent of Public Instruction where all the pupils were brimful of college-preparedness and workplace-readiness. One would think Indiana had a system of water pipelines and an electrical grid that not only did not date to the Depression Era, but set the standard for 21st-century America. One would think the Hoosier State had a low rate of childhood poverty, farmland in reserve, superior and structurally sound roads and bridges, and the very highest of employment participation and the lowest levels of political corruption. Because if all those things were true, then the first priority for the governor in 2015 might be restructuring his publicity and press releases; might even be creating a news outlet to provide stories which tout how wonderful Indiana is under a Pence administration (even the working poor can have health insurance now!). But if even one of those things is not true*** then, as a priority, better publicity shouldn’t have made the cut. Not in January. Not in 2015.
This Just IN: Governor Pence had a bad week. But he co-paid for it. Let’s see what he does with the rest of his year.
***Just for starters, on infrastructure (roads, bridges, wastewater, drinking water), the American Society of Civil Engineers gave Indiana a grade of D+ for 2013. The report card is here. On childhood poverty, the percentage is roughly 23%.