Republican senators won't block Medicaid expansion funding

Republican leaders of the state Senate say they will not block the estimated $250 million in spending needed to pay the state's forthcoming share of the Medicaid expansion in the two-year state budget that begins July 1, Adam Beam reports for The Associated Press.

Under the Patient Protection and Affordable Care Act, outgoing Democratic Gov. Steve Beshear expanded the federal-state Medicaid program to include those with household incomes up to 138 percent of the federal poverty line. Republicans were skeptical of the move but could not block it; state law gave Beshear the authority to act without legislative involvement.

The federal government is paying the full cost of the expansion through next year. In 2017 and 2018, Kentucky will be responsible for 5 and 6 percent of the cost, respectively. This cost will eventually rise to the federal health-reform law's cap of 10 percent in 2020.

A state-funded study by Deloitte Consulting said the expansion will pay for itself through 2020 by creating health-care jobs and generating tax revenue, but Republicans and Republican Gov.-elect Matt Bevin scoff at it. The actual jobs created appear impossible to track, but the total gain in health-care jobs since the expansion began appears to be about two-thirds of the number of expansion-related jobs predicted by the study.

Bevin, who won the governorship by almost 9 percentage points and takes office Dec. 8, campaigned on scaling back the Medicaid expansion and had called his victory a mandate to enact his policies, Beam notes.

However, revising the program will require time and the approval of federal officials, and Senate President Robert Stivers told reporters at the start of a two-day Republican caucus retreat in Maysville that the Senate does not plan to block the $250 million budget request, Beam reports.

"Just as Gov. Beshear implemented by executive order, Gov. Bevin can deal by executive order. It's appropriate to see what direction he wants to go," Stivers said. "I think you saw this from Gov. Bevin during the campaign as he became more familiar with the issues saying, 'We want to transition, not to just totally stop it'."

Bevin has appointed Louisville health lawyer Vickie Yates Brown Glisson to oversee the Cabinet for Health and Family Services, which includes the Medicaid program.