Legislators talk nuclear power, prior authorization

A complete livestream of the event may be found at youtube.com/watch?v=D64q_KGQO2E or through the City of Auburn’s website.

The event was hosted by the DeKalb County Economic Development Partnership and moderated by DCEDP president and CEO Anton King.

Prior authorization

An emergency room physician, Johnson talked about Senate Bill 480 that covers prior authorization reform.

“Prior authorization is when your doctor says you need a procedure and your insurance says, ‘Wait, we want a have a yes or no answer on that.’

“If you’re involved in health care at all, you know how ridiculous the system is and the back-and-forth from a physicians’ office or a physical therapy office and the insurer,” he said. “You call and there’s somebody maybe in the United States or maybe not, may have a medical education, probably doesn’t at this point.

“A lot of times, it’s artificial intelligence going through a database that they automatically deny what your doctor says is necessary,” Johnson said. “It’s pretty absurd.

“Their goal, on the insurance side, it appears to be just delay payment so they can invest those dollars and make money off of it,” he continued. “Most of them are publicly traded companies, and the bigger they get, the worse they get on these things.

“We’re trying to push the market, and even in Medicaid, Medicare, push the envelope there so we can get you the care you need sooner,” Johnson said.

“When you look at it, it’s common sense. If you get the medication you need, you have less ER visits, you have less complications long-term. (Insurance companies) use the idea of it being fraud, abuse or waste even, when in reality, they’re not making that decision based on that,” Johnson stated.

“The bill we have gets rid of all of the headaches in prior authorization, makes it a very common sense system and gets all of those things done in a timely manner — two weeks at most to get to a no answer or a yes answer, and those are only in the worst cases.

“We’re allowing 48 hours which everybody thinks is a very quick time-frame, but we exclude weekends and holidays. Forty-eight hours is enough for most people to make a decision on those things,” Johnson continued. “Then we make the insurer tell us why they’re denying so you have a very specific reason as a physician to come back to them. If the physician can answer that and give them the information they say, then it’s automatically approved.”

Glick speaks

Glick thanked Johnson — who she noted is one of the younger members in the state legislature — for his input from the medical field.

“We all are affected by the health care industry and the escalating prices,” Glick said. “When you talk about some of the nuances and the terminology in the health care end of things … Tyler’s presence has been very, very valuable to the Indiana Senate and the General Assembly as a whole because he brings real-world experience.”

She shared Johnson’s stances on transparency and price caps.

“I know that I want to be able to go to a hospital if there’s a health emergency, I want to make sure the care is available and we don’t lose that facility,” Glick said. “The grayer my hair gets and the older my bones get, the more important it gets to be.

“What is very concerning to me is the whole idea of price caps. I don’t want the expenses to go out of control like everything else, but by the same token as a Republican, I have problems putting limits on a system where some of those entities will no longer survive if they can’t make enough money to pay for skilled care.

“We know there’s a shortage of nurses across the board in all areas … if we start saying you can’t charge above this or you can’t charge value for value received, what happens to the people along the way who have to be employed in those capacities?”

Glick said she has several bills dealing with clean water. She said she has been working with Farm Bureau and other farm entities to add invasive species language to clean water legislation to give soil and water conservation districts the ability to use funding to keep waters clean and to control filtration, soil erosion and invasive species.

“We want to give more tools to the experts so they can use these things to protect all of us and to protect water,” Glick said.

Medicaid was drastically expanded during COVID, she noted. “Many families grew dependent on that money. It was necessary during COVID because in-home providers weren’t available.

“We want to get this back in line because the cost exploded so terrifically during COVID,” Glick said.

Modular nuclear power generators

Discussion also included alternative energy sources. While solar and wind have been discussed in many counties, other ideas have included water, hydrogen, nuclear and coal.

Several groups are working together to adapt small modular reactor technology for power generation. Many are made in southern Indiana by Babcock & Wilcox Enterprises, Smaltz noted.

“I talked with a Navy submarine captain. He said, ‘We expect zero percent leak because we’re all dead if it leaks one little bit in that tube.’

“You’re very likely to see these start going into repurposed coal mines because they’re already sub-grade and the infrastructure is largely there already,” Smaltz explained.

“I don’t think we’re going to see them in northeast Indiana any time soon; we’re going to get the juice but we’re not going to see the plants here,” he added.

As of now, Smaltz said he is hearing a seven-year turnaround time from project inception to generating power.

“SMRs, the nuclear reactors, get a bad rap because you think of the large nuclear reactor plants,” Johnson said. “It’s not even the same technology when you think about it. It’s nuclear, but it’s not even close.

“I would stick a nuclear reactor in my backyard and not even think about it,” he said. “These small nuclear reactors have been on subs and on aircraft carriers. We’re talking 50-year-old technology with a really good track record.”

Summing up

“We’re going to balance the budget,” Smaltz said. “We’re not going to spend money than is coming in. We’re going to save money for a rainy day. We’re not going to spend money we don’t have.

“We won’t know until April 16 when we get our forecast, how much money we’re going to have.”