The Indiana General Assembly reached the halfway point in their twenty twenty five session meeting a legislation approval deadline by passing more than fifty bills alone on Thursday and all the measures that have passed out of their original chamber are now moving to their opposite chamber as lawmakers take a mid session break priority bills passing include the House version of a new state budget and the Senate's property tax relief package.

Other notable measures include bills to streamline prior authorization requirement for medical care, establish greater oversight of pharmacy benefit managers, expedite county coroner communications and incentivize nuclear power development.

>> Our guests from the Indiana House and Senate offer their thoughts on the General Assembly's first half activities on this week's PrimeTime.

And good evening.

Iverson's with us tonight is 14th District Republican state senator and assistant Majority Caucus Chair Dr. Tyler Johnson and 18th District Republican state representative and Assistant Majority Caucus Chair David Ebon And you can join our conversation by calling in your questions and comments.

Just use the number that you see on the screen as here we all are welcoming you to this broadcast.

We as Senator Johnson, Representative Abbott, Tyler and Dave gentlemen, thank you for being here.

>> Thank you.

Thank you.

Really great that let me begin by just getting your thoughts on this very fast it seems first half of the session.

>> Yeah.

I mean this I've been this is my third session.

I'd say it's relatively twice as fast as the last two sessions, even quicker than a short session where things tend to move pretty quickly.

We started out of the gate which is very different and hit the ground running and we had a lot of different ideas to tackle some big ideas.

>> I think that's part of it.

Dave, how about you what was a little different in the House taught or Todd Houston our speaker said we're going to take it a little easy at first and not push it too hard.

So the first week we did not do a lot.

We had a session I think one day and then we had committee meetings start started to ramp up in the second week and towards the end of the second week we just we hit it full speed.

>> It's been flying ever since both shoes have dropped.

Of course one of the things that is key to this year is the House is passage of its primary measure, the proposed two year budget.

It's been said to mirror parts of Governor Brown's version as it moves to the Senate.

What's your takeaway on the House side from the chambers plan so far?

>> Well, I think we've got a good solid budget balanced structurally.

We have a surplus and we also have a rainy day dollars.

But our our forecasts our December forecast are showing, you know, that we need to cut back a little bit and just be wary of what could happen in the future, especially with federal tariffs and other cost cutting measures that you're seeing might trickle down to the state.

So we've got a watchful eye on that but yet we're still maintaining a triple-A bond rating with a balanced budget and that's our key.

We want to stay that that's what entices our businesses to come in.

That's what helps our economy be strong in Indiana.

>> So to tell you the budget includes fully funding the Medicaid forecast and I recall SB two is related to Medicaid eligibility and there are some reforms to the healthy Indiana plan.

You're intimately familiar with what's known as SB two where where does that stand relative to the budget and in this halftime moment here?

>> Yeah, if you remember last time around we had a little bit of concern over some forecasting errors in Medicaid .

It really was it an error as much as it was just rapid growth and some of the programs in Medicaid and so during covid a lot of people that signed up for Medicaid are no longer eligible or they have kind of grown out of the program and so we're really asking for SSA to take a hard look at the eligibility requirements and folks that are on it.

So we have the finances and the dollars there to take care of the people who really need it.

>> Senator Mitchell says this is a right sizing move for Medicaid.

>> Would you agree?

Yeah, absolutely.

I spent the back half of summer looking at this.

I actually authored my own bill on Medicaid reform and then we ended up putting most of those into SB two and Senator Mitchell as our appropriations chair.

So the perfect person to help steward through that and we're right where we need to be good.

>> It will soon be time.

Dave, for you and House members to see what the Senate is sending your direction regarding Medicaid, regarding the property relief package when those deliveries occur walking across that hallway, what will you be looking to see on these matters in the coming weeks?

>> Well, on the especially on the Medicaid, you know, we have to be really concerned with how that's been escalating right now with education in about forty seven point six percent of our budget and Medicaid is about another 22 percent plus secondary education is nine percent approximately year up into the seventy five percent of our total budget.

So I think we're going to be looking for good policy that doesn't add to the budget but yet we have to maintain Medicare or Medicaid without cutting into that.

There's a process with access that I understand we need to address and you know, that's going to be that's going to be a challenge and it's the halfway point.

So we've got a lot of time and there's going to be a lot of a lot of back and forth.

>> We get to that part that spot where it's it's manageable I think is what I want to say.

And when the box arrives with the budget for the Senate to admire and take a look at and analyze and see if the pieces still fit, what are you looking to take from some of that study?

>> Yeah, so I mean a lot of the budget we're really looking at making sure we're right sizing some of the programs we have to make sure there's dollars there for things like Medicaid, for the voucher program, things like that.

And so we'll just now start taking a look at most of the budget proposals and Senator Mischler, our appropriations chair like I talked about, he'll have a lot of ideas of his own and we'll start discussing those things.

>> Yeah.

What are the bills that has made it to its next step along the way?

The Senate Committee on Appropriations passed your bill, Tyler on prior authorization said a bill for eighty you've been advocating for changes to prior authorization for for many years.

>> Why?

Yeah, I mean this is something that was really important to me when I ran for office.

I think a lot of times the frustration as a patient is actually getting access to the care that you know you need and your doctor says you need and actually you've already paid through through your premiums.

And so whether the blood pressure medicine or MRI or things that are really medically necessary and your doctor says they are we want to get rid of the headaches that are involved with getting you there.

So if your doctor says you need a blood pressure medicine show up at the pharmacy and now your insurance company says well wait, we don't really want you to be on that blood pressure medicine.

Well, your doctor already said that you do so now they say you can't get it.

You can go back to your doctor.

They got to call the insurance company and now you've got weeks to wait for approval.

That just doesn't make sense.

So we're trying to add some common sense and get rid of the headaches in this process.

>> What relationship, Dave?

Some of this play with I think it's Tennessee dealing with some medical matters on the House side is this the companion bill to two four eighty or taking a part of four eighty into the into that yeah ,and this is also part of House priority legislation so that will now come over to correct the Senate to see what's going on.

>> Yeah, we we are dealing with, you know, increasing hospital costs and especially nonprofits that we have a balance there with the costs versus services provided and realizing that, you know, if you're paying exorbitant amounts of not going to give you an example, there's special bandages that were charged sixteen thousand hours after insurance would adjust the premium the discounts it was five thousand although one of the constituents went out on his own and was able to obtain them for six hundred dollars.

Now these are not the little bandaids.

These are sophisticated bandages but it just shows that there's a there's a disparity disparity about the cost and then what with reimbursements that you get with the patient actually ends up paying is this is what we want to address also is to get that in line and with nonprofits we are going to be proposing it's it's in the bill that there would be a 300 per cent over the Medicaid reimbursement rate.

If the prices are higher than that, then they would be potentially in line to lose their nonprofit status which they would be able to earn back.

But this would be a deterrent to for them to start looking at ways to have better pricing and marketing your watching prime time on PBS Fort Wayne.

We're speaking this evening with State Senator Tyler and Dr. Tyler Johnson and State Representative Dave Abbott and we invite you to join us as Jeff is doing online three.

>> Jeff, welcome to Prime Time.

Sure.

Go ahead with your question or comment, please.

Sure.

Thank you for taking my call in the introduction to your program you talked about possible among some other topics that you brought up nuclear power and I know Representative Abbott I believe is pro commercial nuclear power up here in Noble County.

I think the county government has just gotten off the mark and they're ready to sort of move things along and it seems to me like solar is much more feasible, much more timely compared to nuclear.

Those kind of projects seem like they never get going or they just never really pan out .

Solar seems much more feasible.

Could you discuss maybe contrast the two and then how solar is being used in some of the other surrounding counties here to Noble County?

>> Thank you for taking my call.

Yeah.

Jeff, thanks for checking in and Dave, go ahead.

Thank you Jeff.

I'd glad to answer that question.

I am from Noble County, used to be a former commissioner in Noble County.

So I do understand what they're going through right now and they did have a meeting where they were going to add another year to the moratorium but I believe they did vote that down so that they could greenhouse or companies like that or solar could come in and start to entertain permits to put solar fields in the thing with solar fields there are transitional renewable energy source.

I really believe the Earth and Mars are small modular reactors are the way of the future.

Just think of a submarine.

These are very small.

They're very safe.

They don't melt down and they're they're unities in a way you can spread them out throughout the county especially where there's power grids nearby in me having meetings with AEP and Indiana.

Michigan your solar is never going to be more than just a couple percent of the demand that we need and with the new data centers coming in, you know, even cook nuclear plants only producing about two point four two point five gigawatts of power these these data centers alone are going to require at least that much or more and that's double what we have now in generation capacity.

So in our coal plants are being retired.

I think solar is at its place.

It's going to be a transitional I think the absolute end of everything is going to be small modular reactors.

>> That's probably an eight year process but I think nuclear or solar has got its place for now but it's not going to be a solution and you're on House Bill ten or seven if you're scoring at home it's this one is dealing with in fact energy generation resources and as it's title what does that bill allow for the nuclear power providers to do?

>> Well, it's going to allow we're going to try to fast track that process a little bit.

>> That's that's the main thing.

We also have got to get more people at the table so that we can get this into the state regulations.

Really what's going to be a new power plant is going to take you ten, 12 years full sized nuclear plant.

We want to focus on the smaller ones because we think we can expedite the process.

That's the main thing right now is they are being tested there.

I don't believe there's I think there's one in Indiana that's going to be proposed maybe in that process right now.

But expediting that process is really what we need to focus on and that's going to take some infrastructure and some regulations that need to be changed a little bit.

>> So anything you like to answer?

>> Yeah, no, I think he highlighted on the expedited process.

I think it's really just getting it's not expedited as much as they're just getting the government to get out of the way so we're not slowing it down.

So much.

And so that's part of this is the technology's been there for twenty, thirty years.

We're just now starting to adopt it into real world environments and so people immediately start questioning the safety and the placement and those kind of things that will all still be looked at.

But I think he's right in saying that if if solar could take another jump in efficiency and production we might get there but we're not there right now.

So to keep up with demand nuclear is probably the only option.

>> Jeff, thank you very much for your call, sir.

And if you anyone else that is so interested, there is time on the clock to connect with our guests here tonight.

Just use the number you see on the screen.

>> Tyler, you've authored coauthored a number of bills in the medical or health care field and this isn't even a complete list measures related to pharmacy benefit manager surgical certificates of public advantage, physician referrals, reimbursement rates, physician non compete agreements which I recall has a history in the legislature of its own.

Which of these or maybe others are you encouraged to see some progress on this session?

>> Yeah, we always tackle a number of health care bills and so being the physician in the Senate I get be asked to weigh in on a lot of them.

So I like to work on the bills and you know, I think probably the biggest thing that we're doing is one we already talked about the prior authorization form but pharmacy benefit managers are also another big add to health care cost.

So it's a middleman in the process that originally was there to help negotiate contracts for businesses against pharmacies.

Well, it's kind of gotten out of its lane and through both horizontal and vertical integration it's adding a ton of cost to the system.

Most people don't even know they exist.

But it's a big issue that we're trying to tackle.

I think the form the bill is now I added an amendment on second readings.

Senator Charboneau, our health care had the bill in great shape otherwise we just made it probably the most aggressive PBM bill in the country by far walling off big insurers and the PBM from pharmacies so that they actually function the way they're supposed to be and there's not that undue manipulation in the space got.

And Dave, you were nodding in recognition regarding that activity and of course a House committee somewhere will be having this to look at.

>> Yeah, I can't agree more than I can with Dr. Johnson.

Representative Dr. Johnson I may say.

But no, they they started out as you say, it's kind of a safety net kind of to try to help reduce rates and it's got to the point where there's kickbacks and there's all kinds of incentives between premiums and they're dictating to insurance companies I believe when I understand in a way that pricing is you think it's a pharmacist over pricing you find out the pharmacist is not the one that's and it's the insurance company.

>> But then the insurance company has been directed by pricing through the PBM.

So it's it's not something I fully understand.

I'm not it's not my wheelhouse but it's enough that it's really a problem.

>> One of the bills we mentioned a second ago feels like to me ask you are we close to closure on non compete agreements?

>> I think we're there.

There's definitely an appetite to take care of non compete agreements for physicians.

You know, lawyers have a ban on non competes because they're an essential good.

If you have to have a lawyer, you need a lawyer right?

Well, I think we can call doctors a more essential good than lawyers and it's really harmed our rural communities the most health systems or even some private equity groups are holding doctors accountable to non competes and then they just move out of Indiana or the area completely well, what good is that?

And so there's other ways to contract and do things to hold people accountable for costs that you may have accrued by bringing them into an area non competes are not the way to do it and one another take too because there was a time and perhaps it is still with us where a growing field of need in fact was nursing and the bill regarding licensed practical nurses is this one in fact to try to answer get supply and demand all where they need to be.

>> Yeah, so Senator Yoder, one of my Democratic colleagues on the health committee authored this bill primarily and it's it's interesting to see as we move education more into high school and Realm's there is limited access for those students to get into courses that they can start their LPN and so allows them to at least start before they get into college and get some of those prerequisites out of the way just like you would for an accounting degree or an engineering degree.

It makes a lot of sense to to get those done early.

>> You still have to meet all the requirements once you get to the program but allows you to take some of those courses earlier.

Yeah, it made me smile to find in preparation for tonight that both of you gentlemen are on at least two bills together and one of them in the house dealing with county coroner's where Dave you are the author and Tyler you're the Senate sponsor.

>> Dave, tell me what House Bill 1094 seeks to do here.

>> Well, it was brought to me by the coroner's association and it's to clarify some language first of all that was passed two years ago Four Corners there's one when you have an incident where let's say let's just take for example, I'm in Noble County there's an accident but you get there airlifted to Fort Wayne State to Parkview that would be and they pass away to an emergency room that would be the county of the death.

So the process right now is that the coroner in that county would contact the coroner in Noble County in this instance to decide who's going to pay for the autopsy if there's a need for the autopsy, whether if they agree there is then the county where the incident happened would if they don't agree there is no provision in that in statute.

So we're clearing that up and then there' some billing back and forth issues that are in question how that's done.

>> There's been some issues where one corner will go ahead and Bill anyway Bill, the other county without their knowledge and it's and their untimely responses back and forth.

The main thing we're trying to do is protect the investigation at a corner is going to do what needs to be done in a timely manner and blood draws or another issue that when when they were admitted into an emergency room or maybe into the hospital they need a fresh blood draw that's kept more than two or three days in case they're released or they get admitted into the hospital, then what's going to happen is if they pass then the blood samples gone.

>> So we need to preserve that and keep it for a longer period of time.

>> We're suggesting 21 days.

Anything further on that?

Yeah.

So I mean it's kind of a neat way to highlight the process is that he's got that bill in pretty good shape coming out of the House and has asked me to work on it.

Look at it further and that's the world I live in.

Right.

So we take care of those patients and unfortunately sometimes they pass away and sometimes it's not natural causes.

So the corners want to take a look at things further.

We got a great corner here in Harlan County.

We'll talk about things and and the process and understanding the process of how we draw blood and where we hold it.

>> Those are big things that we still need to talk about a rather unique bill and I'll ask you to to give an overview is the one where you are the author and the representative is your sponsor in that regards anatomical gift inquiries.

>> Yes.

This bill is interesting because you know when you go to get your driver's license you can say hey, I'd be interested in organ donation, tissue donation, those kind of things.

Well, the state has millions of other opportunities to do that and for state employees we don't necessarily have that direction when you go to sign up for something or those kind of things.

So that Bill's asking that a lot of those employment opportunities and when you sign on as a state senator or state rep that they ask you hey, are you interested and so it's a kind of an interesting bill from that standpoint.

Dave, anything you want to?

Well, I can speak from experience on that.

I had a kidney transplant just coming up on three years ago.

I was very fortunate my son was the donor that was a living donor.

But I was told I was going to go on to dialysis and I could have waited a number of years which my health would have deteriorated and would have completely changed my life with dialysis a number of times a week.

So I think it's really important that we reach out to more people and give them that opportunity to donate an organ and that's what the bill is trying to do.

We're trying to reach a larger ,larger audience.

We have twenty twenty four thousand employees.

We want the bill to reach out to them and give them that opportunity.

You can already do it with your license.

You sign on for a BMV, the license you can sign on there.

>> We're just providing more opportunities so that we can get more people to donate outside those bills that we've had a chance to speak up so far in the show.

Are there other pieces of legislation you are connected with you'd like to mention and you have each about a minute piece to in which to do that?

>> Yeah, a minute's not enough time for property tax reform discussion but that's a big piece SB one a big piece of Governor Brauns which personally I'd like to see us move away from property taxes but that's a big bigger discussion that we could have in one session and but they've got a good discussion on the House side now that we moved the bill over there to figure out where to land to help give people some relief from elevating property taxes Dave.

>> I got you, sir.

Well, I have a bill I have a bill on squatters rights property rights really for someone that has they go to Florida, they come back and there's someone living in their home and it's a problem that's starting to grow.

We're trying to address it and get ahead of it before it becomes a problem.

We have to try to resolve, you know, after it's happened and this will provide an affidavit process where property owner can go to their local law enforcement or their sheriff sign a document testifying basically to perjury that they would are the owners.

There is no landlord tenant relationships and this what this expedites the process that an eviction process or a writ of assistance would require.

It could be multiple times and the court could take days weeks.

This could happen within hours if this bill is to pass it didn't it did not get a hearing or I should say it didn't get a hearing.

>> It didn't get passed through in the House.

But there's another bill Senator Gaskill bringing it over on co-sponsor on that bill and we're going to address that.

>> Got it.

So I have to address this.

It is not often that this program has two lawmakers, each of whom is assistant majority caucus chair.

>> I think it's like the slot machines all came up with the same I can Taylor, tell me briefly what it is that that title implies.

>> What are the associated responsibilities?

So Senator Holdman is our caucus chairman somebody that we elect as a caucus?

My job is to assist him in all of those things.

Pretty easy answer but no, it's organizing the caucus, making sure information gets out, make sure questions get answered and when we're in that caucus room making sure that everybody called on and identified get their questions answered and send sources in the house, you know, it's like a vice president.

You're there when you're needed but you also stay in tune with the caucus chair.

They run the caucus for the most part and you listen and learn a lot and you're there they you them and something would happen and you would step up for that position.

>> Well, I have listened and learned a lot and I thank you both for assisting me in those positions and with your work in the legislature we've been speaking tonight with Republican State Senator Dr. Tyler Johnson and Republican State Representative Dave Ebbitt.

>> And for all of us with prime time, I'm Bruce Haines.

Thank you for watching and we'll see you next week.

Good night