Healthcare Is a Right: Building a Bridge to Better Care
A reflection from Kelsey Kauffman on what we can do, right now, to make healthcare work for the people who live here.
I believe healthcare is a basic right. Not a perk of having the right job, not a reward for being wealthy enough, not a privilege you have to earn — a right. The same way I believe a child has a right to be educated, and a senior has a right to live with dignity, and a worker has a right to be paid fairly for the work they do. If we say we are a community that takes care of one another, then healthcare cannot be the place we make an exception.
I also believe in being honest with people. We are not going to wake up tomorrow morning in a country with Medicare for All. The system we have was built over generations, with millions of jobs, hundreds of billions of dollars, and a tangle of insurers, hospitals, and employers all woven into it. You cannot pull a single thread on that without the rest of the cloth moving.
What we can do — and what I am running to do — is build the bridge. We can close the gaps in the system we have right now, so that fewer people fall through them while we work toward something better. That is not a small ambition. For a family in our community whose kid finally gets the mental health appointment, or whose grandfather can afford his insulin, or whose mother does not have to drive ninety minutes for an OB visit, the bridge is the whole world.
Healthcare and the Cost of Living Are the Same Conversation
When I talk to people in our community, healthcare almost never comes up by itself. It comes up tangled together with rent, with groceries, with the cost of childcare, with whether a family can stay in the home they have lived in for thirty years. A surprise medical bill is one of the most common reasons American families file for bankruptcy. One in five Hoosier adults reports skipping or delaying care because of cost. Roughly one in ten is carrying medical debt right now.
That is not just a healthcare crisis. It is an economic crisis. Every dollar a working family in our community sends to a collections agency is a dollar that is not going to a mortgage payment, a school field trip, or a tank of gas to get to work. When we talk about why wages do not stretch the way they used to in this district, healthcare is sitting at the center of the table — whether we name it or not.
And there is something we already know but rarely say out loud: delayed care is the most expensive care there is. The diabetic who cannot afford the $300 prescription ends up in the emergency room with a $30,000 admission. The mother who skips the prenatal visit ends up in a NICU. The teenager whose anxiety goes unaddressed for two years ends up in a crisis center, or worse. We are paying for this care either way. The only question is whether we pay for it early, when it is cheap and humane, or late, when it is expensive and devastating.
What Indiana Has Been Doing — And What It Has Cost Us
I want to be plain about something. Over the last few years, our state government has been moving in the wrong direction on healthcare, and the people paying the price are the families I want to represent.
The 2025 state budget imposed new work requirements and tighter eligibility rules on the Healthy Indiana Plan, the program that covers more than 700,000 working Hoosiers — many of them in jobs that do not offer insurance. Tens of thousands of people are projected to lose coverage not because they stopped working, but because the paperwork is designed to be hard. We have seen this experiment run in other states. It does not save money. It just makes sick people sicker.
The legislature has chipped away at the Jake Laws and at funding for the 988 crisis line, even as suicide rates in rural Indiana climb. It has restricted access to reproductive healthcare in ways that have driven OB providers out of small towns and made Indiana's already-dismal maternal mortality rate worse. It has been slow — sometimes hostile — to telehealth expansion, even though telehealth is the single most powerful tool we have for reaching the rural counties where there are not enough doctors to go around. And it has done little to rein in the pharmacy benefit managers and consolidated hospital systems that quietly set the prices Hoosier families pay at the pharmacy counter and the front desk.
This is a deliberate trajectory. It is making care less accessible, less affordable, and less effective for everyone in our community — and we have to reverse it.
What We Can Actually Do in One Term
If elected, I will be one State Representative. I will not single-handedly remake Indiana healthcare. But here is what I believe a serious legislator from our community can fight for, and win, in one term:
- Protect the Healthy Indiana Plan. Roll back the new work requirements and paperwork traps that kick working people off coverage they have earned. If we want people to work, we should not punish them by taking away their healthcare the moment their hours dip.
- Defend our rural hospitals. Our Critical Access Hospitals are operating at a loss right now. The state can stabilize them through targeted Medicaid reimbursement increases, a rural hospital relief fund, and an end to policies that quietly route revenue away from the small hospitals and toward the consolidated systems.
- Expand telehealth, especially for mental health. Make permanent and broaden the telehealth flexibilities the pandemic forced us to adopt, including reimbursement parity, audio-only visits for seniors and broadband-poor households, and licensure rules that let providers serve patients across county lines.
- Cap the cost of insulin and life-sustaining prescriptions. A growing number of states have passed monthly out-of-pocket caps on insulin and asthma inhalers. Indiana should be one of them. No Hoosier should ration medication that keeps them alive.
- Take on the pharmacy benefit managers. Pass real PBM reform so that the price your pharmacist charges you reflects the actual cost of your medicine, not a hidden middleman markup. Independent community pharmacies — the kind that still exist in our towns — are being squeezed out. We can fix that.
- Establish a Prescription Drug Affordability Board. Give the state real authority to review and limit excessive price increases on the drugs Hoosiers depend on, the way several other states already do.
- Fight maternal mortality where it actually happens. Make permanent the 12-month postpartum Medicaid coverage Indiana adopted, fund the Maternal Mortality Review Committee so it can do its work, support rural OB units before they close, and expand programs like Project Swaddle that meet families where they are.
- Put mental health where the people are. Fund school-based mental health services, fully fund 988, expand the loan-forgiveness programs that bring counselors and psychiatrists to underserved counties, and finally enforce mental-health parity so insurers cannot quietly pay less for a therapy session than for a knee scan.
- End surprise medical billing — and make it stick. Federal law made progress here. Indiana enforcement has not kept up. We can fix the gaps so that no family in our community gets blindsided by a five-figure bill from an out-of-network anesthesiologist they never met.
None of these are radical. Most have passed in other states under both Republican and Democratic governors. They are the bricks of the bridge.
The Bridge, and the Far Side of It
I am not going to pretend any of this gets us all the way to the system I believe we deserve. Universal coverage — Medicare for All, or whatever name we end up giving it — is a longer fight, and it is mostly a federal fight. But the moves I have laid out above are the ones that put real care in the hands of real people in our community. They lower out-of-pocket costs for working families. They keep our rural hospitals open. They get a kid into a counselor's office before a crisis, not after. They take some of the most predatory practices out of our pharmacies. They stop the bleeding.
And here is the quiet promise of the bridge: every step of it makes the next step easier. A community that has watched its hospital be saved by the state is a community that learns the state can help. A family that finally got their child into therapy is a family that knows what it looks like when the system shows up. The case for universal care has always been strongest in the places where small, concrete things have actually worked. Indiana can be one of those places.
I am running because I believe the people of our community deserve a healthcare system that treats them like neighbors, not like risks. Like patients, not like profit centers. Like Hoosiers, full stop.
We are not going to fix all of this in one term. But we can start. And starting matters.
Paid for by Kelsey Kauffman for House District 44