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Thursday, June 11, 2015

Bevin says he will end all Obamacare programs in Ky., including Medicaid expansion that has added more than 400,000 to rolls

Matt Bevin, the Republican nominee for governor, has made clear that if elected he would end the Medicaid expansion that has provided free health coverage for more than 400,000 poor Kentuckians.

During his primary campaign, Bevin never made that quite plain, saying he would close the state's health-insurance exchange, Kynect, because it would cost "hundreds of millions of dollars." Kynect is paid for by insurance companies, so Bevin was alluding to to the state's projected cost of expanding Medicaid, which enrolls through Kynect.

The Washington-based publication Politico reported on June 10, after interviewing Bevin, that he would not only close Kynect but roll back the Medicaid expansion: “You may or may not have access to Medicaid going forward,” he said. “People are not on it for extended periods of time. It’s not meant to be a lifestyle. It really isn’t. The point of it is to provide for those who truly have need.”

Democratic nominee and Attorney General Jack Conway, with Gov.
Steve Beshear; GOP nominee Matt Bevin (AP photos via Politico)
Gov. Steve Beshear "is furious" about Bevin's plan, Politico reported. “I am not going to allow someone to become governor of this state who wants to take us back to the 19th century,” the governor said in a telephone interview. “For a serious candidate for governor to be advocating a simple repeal of the whole program without offering any kind of alternative which will continue health care for these people is irresponsible.”

Beshear expanded the eligibility rules for Medicaid as part of implementing the Patient Protection and Affordable Care Act, raising the income limit to the law's required 138 percent of the federal poverty level, from the state's previous level of 69 percent.

The federal government is paying the entire cost of the newly eligible Medicaid recipients though next year. In 2017, the state would begin to pay 3 percent, rising to the reform law's cap of 10 percent by 2020. A study by Deloitte Consulting and the Urban Institute at the University of Louisville  — "which Republican critics have rejected as spin," Politico says — has said the expansion more than pays for itself through 2020 by expanding health-care jobs and generating tax revenue.

Jobs are growing as projected by the study, according to the Cabinet for Health and Family Services, which handles Medicaid.

Cabinet spokeswomnan Jill Midkiff said the study estimated that 32,000 jobs would be created through 2015 as a result of the expansion. "U of L projected this growth would primarily be in the areas of retail trade, finance and insurance, administrative services, health and social services, accommodations and food services and other services," Midkiff said. "These sectors were estimated to account for more than 28,000 of the 32,000 jobs created." She said the latest Bureau of Labor Statistics figures show that "these sectors have grown by more than 29,000 jobs from 2013 until April 2015. Therefore, the most recent BLS numbers indicate that UofL’s estimates are on target to meet projections."

Politico says a Bevin victory could "blot an Obamacare bright spot," since Kynect has "worked virtually glitch-free." Through April, 106,000 Kentuckians had obtained tax-subsidized, private insurance coverage through Kynect, which is also the portal for enrolling in Medicaid.

Bevin says he would move those people to the federal exchange, which has been marred by technological issues and charges insurance companies much more to use it than Kynect does. But that plan would not work if the U.S. Supreme Court rules this month that the tax subsidies are not legally available through the federal exchange.

"That doesn’t worry Bevin," Politico reports, quoting him: “You’re worrying about a hypothesis. Let’s let the Supreme Court rule.”

And what about the new Medicaid recipients who would lose their benefits if Bevin wins? He "insists that Obamacare is coverage in name only — that Kentuckians still lack access to high-quality health care, partly because Medicaid pays doctors such low rates, partly because he says too many people rely on emergency rooms," Politico reports, quoting him: “Just having health insurance doesn’t mean you’re going to get health care.”

Attorney General Jack Conway, the Democratic nominee, declined Politico's request for an interview. Campaign spokesman Daniel Kemp said, “Jack wants to make sure that the hundreds of thousands of Kentuckians who now have health insurance through Kynect, especially kids, keep their health insurance — not play politics or push an ideology that’s out of touch with Kentucky’s values.”

Politico observes, "Conway is in the tricky spot of embracing Kynect while trying to keep his distance from Obama and Obamacare, a term that still generates ire among Kentucky residents. A September 2014 Marist [College] poll found that 61 percent of registered Kentucky voters had an unfavorable impression of Obamacare. Only 17 percent had negative feelings about Kynect."

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