|Gov. Steve Beshear|
While Beshear's list said it was unranked, it mentioned health first in both a headline and the list of 13 successes. The health item was labeled "Reducing the number of Kentuckians without health coverage from 20.4 percent to 9 percent (according to a Gallup poll)." But it did not specifically mention the Patient Protection and Affordable Care Act, often called Obamacare, a set of health reforms that were controversial and perhaps politically damaging to Beshear and his fellow Democrats -- or his expansion of Medicaid with Obamacare money that will require a 5 percent state contribution in 2017. Beshear's health item read:
Taking advantage of the “big solution” offered by new federal health programs, Gov. Beshear helped bring health coverage to over half a million more Kentuckians. The expansion of Medicaid eligibility and the creation of a state-based health benefit exchange called Kynect (deemed the most successful in the nation) have been enabling Kentuckians to access lifesaving preventive care in record numbers and is already having an impact on some of Kentucky’s most stubborn health problems, such as obesity, smoking, cancer and heart disease, as shown by the year-end progress report of the Kyhealthnow initiative. It also brought nearly $3 billion in direct payments to health providers in the first 18 months of the reform, as the health industry created thousands of jobs to provide that needed care. Kentucky moved to a Medicaid managed-care system in November 2011, saving the state millions of dollars.Hospitals and other health providers have generally welcomed Obamacare and its Medicaid money, but have complained long and loud about managed care, in which patients' coverage is administered by managed-care organizations, mainly subsidiaries of insurance companies, that get a flat fee per patient and make money on every expense they prevent.
Republican Gov.-elect Matt Bevin has said he will scale back the Medicaid expansion and dismantle Kynect. After the Nov. 3 election, Beshear urged him to keep both as they are; before the election, he made no special effort to raise the issue, except in his weekly video on Oct. 28, when he and First Lady Jane Beshear spoke about health, briefly mentioning the Medicaid expansion and federal health reform, and highlighting Kynect, the state health-insurance exchange. The video is at https://www.youtube.com/watch?v=Sf_f4hQUs68.
In another health-related item, Beshear's post-election release said one success of his administration was "fewer pill mills," or "unscrupulous pain clinics who couldn’t or wouldn’t meet new requirements that they be owned/managed by physicians." He cited his worked with the General Assembly to pass a bill that also "reduced 'doctor shopping' by training doctors to recognize abuse and improve their prescribing. Other bills focused on methamphetamines, synthetic drugs and heroin," a narcotic that became much more popular after the pill mills closed.
Beshear also cited "expansion of substance abuse services and more emphasis on education and treatment" and his continuation of "the Recovery Kentucky program, which helps Kentuckians overcome chronic substance abuse and addiction, and move toward a life of sobriety and productivity."