Kentucky could become the first state to reverse expansion of the Medicaid program under the Patient Protection and Affordable Care Act, Frankfort correspondent Adam Beam reports for The Associated Press.
Republican gubernatorial candidate Matt Bevin, along with GOP legislative leaders, says the state "cannot continue to pay for the health insurance of able-bodied adults," Beam writes.
Bevin has said, "I can't make this more clear: there will be nobody in the state of Kentucky re-enrolling under the current Medicaid construct at 138 percent of poverty." He says people need some "skin in the game" to give them "the dignity that goes with making decisions for themselves."
Beyond that, Bevin has given few details, but Beam got a few more from his campaign: "Bevin spokeswoman Jessica Ditto said his plan would not take away health insurance from 400,000 people, as Democrats say. She said some might be offered a new plan that would require them to pay 'token amounts' for a premium. Some might be offered a higher deductible plan coupled with a health savings account."
Beam notes that more than 400,000 Kentuckians signed up for free medical care through the Medicaid expansion to those in households with incomes up to 138 percent of the federal poverty line. The old limit was 69 percent. The federal government is paying the entire cost of the expansion through 2016; in 2017 states will pay 5 percent, rising in steps to the law's maximum of 10 percent in 2020.
Democratic nominee Jack Conway, the state attorney general, has said he would continue the expansion while monitoring its cost. Independent candidate Drew Curtis agrees, and they cite a state-funded study by Deloitte Consulting and the University of Louisville, released in February, that said the expansion will pays for itself through 2020 by creating health-care jobs and generating tax revenue. Bevin, a Louisville businessman, rejects this study.
Beam notes that twice as many people signed up for expanded Medicaid in the first year than state officials had predicted, which more than doubled the expansion's estimated cost to the state in 2017, to $74 million from $33 million. He notes projections that the cost "could swell to $363 million by 2021, further straining finances in a state wrestling with a multi-billion-dollar pension liability."
Beam interviewed several young, working Kentuckians who have benefited from the expansion.
Tyler Offerman, 26, of Lexington, comes from a family with a history of cancer, and says he grew up without health insurance. Since getting coverage through the expansion, he has been able to see the dentist for ongoing dental issues and has a primary-care physician. He also told Beam that being on Medicaid has offered him him the "safety net I needed to take the risk to be a young entrepreneur." Offerman has an adventure-tourism business leading backpacking and hiking trips.
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| Matt Bevin |
Bevin has said, "I can't make this more clear: there will be nobody in the state of Kentucky re-enrolling under the current Medicaid construct at 138 percent of poverty." He says people need some "skin in the game" to give them "the dignity that goes with making decisions for themselves."
Beam notes that more than 400,000 Kentuckians signed up for free medical care through the Medicaid expansion to those in households with incomes up to 138 percent of the federal poverty line. The old limit was 69 percent. The federal government is paying the entire cost of the expansion through 2016; in 2017 states will pay 5 percent, rising in steps to the law's maximum of 10 percent in 2020.
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| Attorney General Jack Conway |
Beam notes that twice as many people signed up for expanded Medicaid in the first year than state officials had predicted, which more than doubled the expansion's estimated cost to the state in 2017, to $74 million from $33 million. He notes projections that the cost "could swell to $363 million by 2021, further straining finances in a state wrestling with a multi-billion-dollar pension liability."
He also notes that the share of Kentuckians without health insurance has dropped to less than 10 percent from 20.4 percent in 2013, the year before the expansion; Kentucky hospitals now have only $60 million in uncompensated care, compared to $160 million in 2013.
Tyler Offerman, 26, of Lexington, comes from a family with a history of cancer, and says he grew up without health insurance. Since getting coverage through the expansion, he has been able to see the dentist for ongoing dental issues and has a primary-care physician. He also told Beam that being on Medicaid has offered him him the "safety net I needed to take the risk to be a young entrepreneur." Offerman has an adventure-tourism business leading backpacking and hiking trips.
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