Friday, August 30, 2013

In its colorful Kynect costume, Obamacare hits the streets in Kentucky and attracts national news coverage

By Molly Burchett
Kentucky Health News

When the Patient Protection and Affordable Care Act takes effect Jan. 1, many Kentuckians may have signed up for the health coverage it mandates without ever associating it with its political label, Obamacare.

This could be a planned marketing strategy or just the result of the state's effort to provide health care coverage to uninsured Kentuckians, but there's no need to anxiously await for Obamacare's arrival in Kentucky; the state's part of the health-reform law has hit the airwaves with a commercial, and the streets with tote bags and flyers in hand. And national news coverage has followed.

Huffington Post’s Jason Cherkis spent a day at the Kentucky State Fair and the next day in Laurel County with workers from Kynect, the state’s online health-insurance marketplace, and while learning much about the Kynect outreach efforts, he reports little about Obamacare. That's because it's not being called Obamacare, a label Republicans devised and the White House eventually accepted.

At the reform law's core is the implementation of health-insurance exchanges and subsidies in each state, which is provided through Kynect in Kentucky, "but little or none of these operations will have the words 'Affordable Care Act,' much less 'Obamacare,' attached to them," writes Jonathan Bernstein of The American Prospect. 

The Kynect website, where Kentuckians can go to sign up for insurance coverage and determine their eligibility for it, doesn't mention the federal government, reports Kevin Drum of Mother Jones in an article titled "Here's Hoping That Obamacare Is Better Than That Appalling Obamacare."

The state site describes the long-awaited (for some) and highly controversial (for more) law: without referring to it directly: "Starting next year, most Americans will be required to have health insurance. By using Kynect, you may receive payment assistance, special discounts or tax credits to help cover the costs of coverage for you, your family or your employees,"it says.

Most Kentuckians probably don't know that the insurance exchange exists, let alone that the exchanges are part of Obamacare. In an August Kaiser Family Foundation health reform poll, only 22 percent of respondents nationwide said they’ve heard “a lot” or “some” about the state-by-state exchanges, which are set to begin selling policies and signing up people for expanded Medicaid on Oct. 1.

Half of those polled (51 percent) said they didn’t know enough about Obamacare to understand how it will affect them and their family, and the number was even higher (62 percent) among the uninsured, the reform law's target population.

The uninsured and newly eligible Medicaid recipients, an estimated 600,000 Kentuckians, are also the target of Kynect's outreach efforts, although they may not be the ones receiving the tote bags at fairs and community events.

Furthermore, the Kaiser survey results show a vast majority of Americans don't know that the health law is actually a law; about 44 percent said they were “unaware” of the current status of the law, with 31 percent of that number  (14 percent of the total) saying they simply didn’t know if the Affordable Care Act was law or not.

This all suggests the possibility that, even as people start signing up for Obamacare in a few weeks, public opinion about the health law won't change, writes Sarah Kliff of The Washington Post. Thus, while public opinion of Obamacare leans to the negative, that may not keep some of its ostensible opponents from becoming users of it.

Kliff writes that the following three paragraphs written by Cherkis say everything you need to know about Obamacare:
Reina Diaz-Dempsey
A middle-aged man in a red golf shirt shuffles up to a small folding table with gold trim, in a booth adorned with a flotilla of helium balloons, where government workers at the Kentucky State Fair are hawking the virtues of Kynect, the state’s health benefit exchange established by Obamacare.
The man is impressed. “This beats Obamacare I hope,” he mutters to one of the workers.
“Do I burst his bubble?” wonders Reina Diaz-Dempsey, overseeing the operation. She doesn’t. If he signs up, it’s a win-win, whether he knows he’s been ensnared by Obamacare or not.
With millions of dollars from the federal government, the state conducted "market research that included holding a dozen focus groups in Louisville, Paducah and London, according to Gwenda Bond, assistant communications director with the Cabinet for Health and Family Services," Cherkis reports. The tote bags are popular, but Diaz-Dempsey doesn't hand one over until the would-be recipient hears her simple pitch, which does mention the law, but without its political label:
We are Kynect -- part of the new health care law.
Do you know anyone who doesn’t have health insurance?
You may qualify for Medicaid or a tax credit based on your income.

"The crush of people don't greet Diaz-Dempsey with tea party dogma or amateur constitutional scholarship," Cherkins writes. "No one is there to complain about the individual mandate or heckle about death panels. They have questions. They wonder if they could get coverage despite having a pre-existing medical condition, how much it will cost them. . . . Could they just enroll their child? They talk about their sons and daughters, neighbors going without health care, and ask about the subsidies. The vast majority are relieved to learn about the health exchange."

Erin Hoben
But the next day in London, in a heavily Republican area, Cherkis encountered many skeptics and outright opponents of Obamacare. He reports that Erin Hoben, an outreach worker with Kentucky Voices for Health, an association of pro-Obamacare groups, told him that a Hazard woman she had been working with "called her recently to tell her that the Tea Party had urged her not to enroll because the exchange wasn’t happening."

Democratic Gov. Steve Beshear, who expanded Medicaid and defended Obamacare in a speech to the fair's Kentucky Farm Bureau Country Ham Breakfast, told Cherkis, “Most people don’t really understand it yet. I do not find that most people have any kind of negative feeling about it. It’s just that most people don’t quite understand the act or what they’re supposed to do yet.”

But the feds like what Kentucky is doing, and the state's only Democratic congressman, John Yarmuth of Louisville, told Cherkis: “I know that the administration believes that Kentucky and Vermont are the two best exchanges that were created, that are models for the country. They’ve said that numerous times to the Democratic caucus.” (Read more)

So, as the Kynect website says, "It’s a new day for health-care coverage in Kentucky. Thanks to Kynect, the power to manage your own care is finally in your hands," regardless if you know it or not.

Click here to view a Kynect factsheet to learn more about the health-insurance exchange.

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