Monday, November 2, 2015

Bevin and Medicaid expansion featured on HBO's 'Last Week Tonight' comedy show; illustrated philosophical divide

Oliver discusses Bevin on "Last Week Tonight."
The future of Kentucky's Medicaid expansion was a topic for liberal comedian John Oliver on HBO's "Last Week Tonight" Sunday night. It was short on facts, but did help illustrate a philosophical divide between ruling Democrats and the Republican nominee for governor.

Oliver focused on elections in three states: Mississippi, where Republican Gov. Phil Bryant faces no opposition; Virginia, where only legislative elections are on the ballot; and mainly on Kentucky, the only state where a governor's race could decide the future of a Medicaid expansion.

"Perhaps the most striking election this year is in Kentucky," Oliver said, noting Democratic Gov. Steve Beshear's acceptance of federal money to expand Medicaid. "Only an idiot would try to undo that. Which brings me to gubernatorial candidate Matt Bevin." Oliver played video of a recent debate in which Bevin denied saying he wanted to kick people off Medicaid, and then an earlier one in which he says he would immediately end the expansion upon taking office.

He did not give Bevin's current position: that he would apply for a federal waiver to revise the program to shift some costs to some recipients. However, he suggested that Bevin might put some Kentuckians in "what's known as the Medicaid gap," created by the Supreme Court when it "struck down the part of the law that enabled the federal government to force states to expand Medicaid." The millions in the gap, mainly in the 20 states that did not expand Medicaid, make too much money to qualify for the program but not enough to afford private insurance, even with Obamacare subsidies.

Noting that Bevin got a state grant in Connecticut to help reopen his family's bell factory after a fire, Oliver said, "The real irony here is that Bevin did not have insurance to cover the fire because he said no company would insure the buildings 'for a price that made sense.' That's right. Because the cost of insurance was too high, he needed to turn to the government for help."

A Kentucky law, passed by a Democratic legislature and governor in 1966, makes it state policy to take full advantage of federal funding for Medicaid. Beshear cited the law in announcing the expansion. The federal government is paying the full cost of the expansion through 2016; in 2017, states will have to pay 5 percent, rising in annual steps to the reform law's limit of 10 percent in 2020.

"I cannot think of anything I would not buy if I had to pay only 10 percent of the price," Oliver said. He cited four Republican governors who have expanded Medicaid: Jan Brewer of Arizona, Chris Christie of New Jersey, Mike Pence of Indiana (in a way Bevin has cited a possible example of his own plan) and John Kasich of Ohio, who is running for president and told an interviewer, "That's not Obamacare, that's Medicaid."

" ... a big dump truck full of money ... "
Oliver said, "All Kasich did was see a big dump truck full of money back into his driveway and not say 'stop'."

Bevin doesn't see it that way. Last week, when an interviewer reminded him that another piece of Obamacare was paid for by federal money, he challenged the questioner and said, "That's our money."

Here's the Medicaid segment of Oliver's show, which runs 14 minutes:

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