Thursday, February 11, 2016

Beshear starts campaign to fight Bevin's moves on health care

By Al Cross
Kentucky Health News

Steve Beshear, the Democrat who was the only Southern governor to expand Medicaid and create a state-based insurance exchange under federal health reform, announced Thursday that he has taken the unprecedented step of starting a lobbying campaign to fight new Republican Gov. Matt Bevin's plans to scale back the expansion and close the Kynect marketplace.

"For reasons he hasn't fully explained, Governor Bevin is working to take health care away from people," Beshear said at a Lexington news conference. "I won't let that opportunity be taken away from those folks, not without a fight." He said the mission of the effort is to make sure all Kentuckians have access to affordable health insurance.

Bevin told reporters that he wants to keep in place as much coverage as possible. He has suggested that better-off recipients of Medicaid should have "skin in the game" through premiums, co-payments, deductibles or health-savings accounts, and has ordered a revamp of the program that will be subject to approval by federal officials.

Bevin warned in his budget speech last month that if approval of his plan is not forthcoming, he would end the expansion, which covers 400,000 people with household incomes between 69 and 138 percent of the federal poverty level, because the state can't afford it.

Bevin has said Kynect does nothing that the federal exchange can't do for Kentuckians, and serves only 2 percent of the state's population while being supported by a 1 percent fee on all insurance policies sold in the state. The federal exchange charges 3.5 percent on policies it sells.

Beshear's press release said the federal exchange is "more costly and unwieldy" than Kynect, "and thousands of Kentuckians could fall through the cracks with the shift." Kynect is used for Medicaid enrollment, and a new system for that would have to be devised.

The federal government is paying the Medicaid expansion's full cost through this year. Next year, states will begin paying 5 percent, rising in annual steps to the law's limit of 10 percent in 2020.

Beshear argued as governor that the Medicaid expansion would paying for itself through 2020 by expanding the health-care system, creating jobs and tax revenue. He cited a study that predicted the expansion would create 15,500 jobs in 2014-15, but data from the federal Bureau of Labor Statistics show that health-care and social-assistance jobs in Kentucky grew by only 10,000 during the period, and some of those would have been created by the economic recovery anyway.

Citing opinions of "leading economists," Bevin asserted in his speech, "Expanded Medicaid does not pay for itself."

Beshear said Bevin has provided no evidence of that. Asked about the jobs figures, he said even if only 8,000 jobs were created, "That's 8,000 more jobs than we would have had otherwise."

It is unclear just how much job growth would be required to make Medicaid pay for itself, but Beshear said, "There isn't any evidence out there that this is not sustainable," and if Bevin has such evidence, "He needs to put it out."

Beshear's press release said his campaign, called Save KY Healthcare, is bipartisan. Asked what Republicans are on the group's board, he cited retired dentist John Thompson of Lexington, who is on the Kynect advisory board. Other members include Crit Luallen, the former state auditor whom Beshear appointed lieutenant governor; Audrey Tayse Haynes, who as his health secretary oversaw his health initiatives; and Bill Hyers, Beshear's political campaign consultant.

At his own press conference, Bevin told reporters that Beshear "seems offended by the idea that I would keep a campaign promise" and is "still scrambling for a sense of relevancy."

Earlier, Bevin's office replied issued this statement: "While Gov. Beshear promotes his political legacy, Gov. Bevin is focused on fixing Kentucky's fiscal crisis after eight years of the Beshear administration's increasing runaway Medicaid costs and refusing to fund the pensions of teachers and state workers to the tune of over $30 billion in unfunded liabilities."

Beshear said at a news conference in Louisville that he has no political agenda. In Lexington, he said it is not a personal or political issue for him: "This is a moral issue."

Beshear acknowledged that he plans to make appearances for Democrats running in March 8 special elections that could cost the party its 95-year-old majority in the state House.

House Speaker Greg Stumbo, D-Prestonsburg, welcomed Beshear's challenge to Bevin. "What the governor really does by dismantling Kynect is put a bunch of Kentuckians under the federal system, which he and others of his party call Obamacare." He added later, "I can guarantee you . . . they will overwhelmingly say they want to stay on Kentucky Kynect and Beshearcare."

A Kaiser Family Foundation poll Nov. 18-Dec. 1 found that 52 percent of Kentucky adults wanted to keep Kynect while 26 percent wanted it closed and 19 percent weren't sure.

UPDATE: Joseph Gerth, political writer for The Courier-Journal, says "We really should have seen this coming," because Bevin has been throwing "broadsides on Beshear."

Information for this story was also gathered by Kentucky Health News reporter Melissa Patrick.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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