Gov. Eric Holcomb is requesting $347 million from the Indiana General Assembly for a dramatic expansion of Indiana’s public health infrastructure that is designed to improve the state’s poor health metrics. The request seeks to implement recommendations of a blue-ribbon public health commission with which ISMA consulted last year.

Holcomb unveiled his 2023 agenda Jan. 4 at an event in Indianapolis. The boost in health spending is part of a proposed $5.5 billion increase in the two-year state budget, Holcomb’s last before he leaves office in 2025.

The public health request reflects the report of the Governor’s Public Health Commission, which Holcomb appointed in 2021 to recommend ways to improve Indiana’s chronically poor rankings across a range of health measures. Indiana ranks in the bottom 10 among the states in smoking rates, obesity, access to mental health services, and childhood immunizations.

Holcomb made his case directly to the General Assembly in his State of the State address on Jan. 10, noting life expectancy is declining among working age Hoosiers and calling it “a pattern we have to reverse.”

“These challenges can’t be ignored or wished or hoped away,” Holcomb said. “It will take new action to get new results where public health is concerned.”

ISMA Vice President of Government Affairs John Ruckelshaus noted the ISMA consulted regularly with the commission during its year-and-a-half of work. “We will be working with legislators to reinforce a health care system in the state that seriously invests in the health of Hoosiers,” Ruckelshaus said. “Physicians should see a more robust local health department with regional assistance.”

The commission found Indiana’s per capita health spending is about half the national average and proposed a sharp increase of $243 million per year to get the state caught up. The Holcomb administration had previously cut its planned funding request for the first year in half, reflecting Indiana’s fiscal year rather than the calendar year, to address concerns from legislators already wary of the big price tag. The formal announcement trims the request by another $16 million.

Nearly all the proposed new spending would be earmarked for local health departments, with counties opting in to a $300 million pool of state funding over two years. Holcomb said that structure will allow counties to tailor their health spending to local needs.

Local departments share just $7 million a year in state money under the current budget. 

The remaining $47 million would pay for a State Health Workforce Council to plan for staffing needs; a state data analytics upgrade to harness data for disease prevention; emergency preparedness, including a state stockpile of needed supplies; and promotion of dental health and child and adolescent health screenings.


Ruckelshaus said the funding boost, if fully adopted, would also enhance ambulance service in rural areas and strengthen Indiana’s trauma network.

Along with implementing the commission’s recommendations, Holcomb’s agenda calls for expansion of the state’s “My Healthy Baby” prenatal care program to the 10 counties that have yet to implement it. The governor is also calling for more resources for mental health, including an expansion of the 9-8-8 suicide hotline, four new mobile crisis teams, an expanded network of community behavioral health clinics, reduced wait times at state psychiatric hospitals, a new program to connect Hoosiers with substance abuse treatment, and $4.2 million to expand a suicide prevention program focused on veterans.

Legislators must pass a new state budget by the April 29 adjournment deadline.