County analysis shows wide range in numbers of previously uninsured who now have coverage through state exchange

Since enrollment for coverage through the Patient Protection and Affordable Care Act opened Oct. 1, more than 255,000 Kentucky residents have signed up; because a goal of the law is to provide everyone with affordable insurance, the Lexington Herald-Leader
looked at county data on enrollments and previous numbers of those who didn't have coverage.

The newspaper found that Perry County has the highest percentage of previously uninsured people who signed up through the Kynect, the state's health-insurance exchange—67 percent—while Owen County has the lowest—17 percent, Mary Meehan and Linda J. Johnson report. For an interactive map and individual county data, click here.

The analysis shows that southeastern Kentucky leads in signups; nine adjoining counties and neighbor Whitley have the highest enrollments. The 10 counties with the lowest percentage of previously uninsured enrollees are Boone, Todd, Anderson, Spencer, Christian, Hickman, Crittenden, Meade, Shelby and Owen. These counties are spread throughout Kentucky.

Courier-Journal map shows county uninsured rates in 2012.

"People in the counties with higher rates of signups say personal connections have helped spur friends and neighbors to sign up," Meehan and Johnson write. Hospital workers, nonprofit staffers and insurance agents have become certified kynectors—those who promote and clarify the insurance process for others. The state provided grants to three agencies—including $600,000 to the Kentucky Primary Care Association—to fund more kynectors. Some Kentuckians may still lack the necessary information about the ACA and how to sign up.

"The kynectors are really great about using their personal networks, churches and families, so there is a face-to-face, one-on-one" conversations someone familiar, said Lindsay Nelson, state coordinator for outreach and enrollment with Kentucky Primary Care Association. She said the system wouldn't have worked had they hired people from outside Eastern Kentucky. The kynectors have even visited places like jails, schools and gas stations to talk to people about health insurance. Nelson said kynectors inform people of their options but warn them about the penalty involved with not signing up.

Kynect Director Carrie Banahan said counties with many low-income people might be enrolling them more quickly because many qualify for Medicaid, which doesn't require premiums. "Of the 231,367 enrolled in health insurance, 181,705 have enrolled in Medicaid," the Herald-Leader reports, using data gleaned before last week's updated number.

Karen Ditsch, executive director of Juniper Health, a public health clinic that serves Breathitt and Lee counties, said relationships are working in her community. "This is a mountain community," she said. "It is small; everybody knows everybody. I think they trust us." (Read more)