Three Kentucky farmers praise Kynect and Medicaid expansion

Ben Abell, Carolyn Gahn and Rae Barr

Three Kentucky farmers praised Medicaid expansion and Kynect, the state health-insurance exchange, at a news conference Feb. 16, saying the programs have helped them to follow their dreams to become farmers, to not have to work two jobs just to have health insurance, and allowed both them and their spouses to work full-time on the farm.

One of the farmers, Ben Abell, called for lawmakers and the agriculture commissioner to "fight to keep Kynect" despite Gov. Matt Bevin's plans to close it and shift users to the federal exchange created by the Patient Protection and Affordable Care Act of 2010.

"Family farmers and other small business owners are the foundation of Kentucky's economy, but I'm afraid our needs are being drowned out by political clamor and the ideological divides over the ACA," Abell said. "If agriculture is to continue playing a major role in Kentucky's economy, then we must ensure the next generation of Kentucky farmers have access to quality affordable health insurance. Kynect was our tool to achieve this."

 Bevin notified federal officials Dec. 30 that he plans to shut down Kynect. And today Health Secretary Vickie Yates Glisson told the House Budget Review Subcommittee on Human Resources that after Feb. 29, Kentuckians will sign up for Medicaid through an online-only program called Benefind, Ryland Barton reports for WFPL. She also noted that the Benefind program would refer those who don't qualify for Medicaid to the federal exchange.

The news conference was held by Keep Kentucky Covered, a coalition that is "focused on sustaining access to affordable healthcare in Kentucky through Medicaid expansion and Kynect," Emily Beauregard, executive director of Kentucky Voices for Health, said at the event. "Farming is one of the industries that has benefited the most from Medicaid expansion."

Bevin has said Kynect is redundant because the federal exchange does everything the state exchange does and it isn't fair that all Kentuckians who buy health insurance are paying for something that relatively few of them use. The federal exchange charges a 3.5 percent fee on the policies it sells; Kynect is funded by a 1 percent assessment on all health-insurance policies in the state.

Keep Kentucky Covered was also formed in response to the governor's plan to change Medicaid in a way that will likely require participants to "have some skin in the game." Bevin said during his budget speech that if the state and the federal government can't come to some agreement on this, then the state will no longer cover the 400,000 people helped by the expansion.

Bevin wants to change how Kentucky serves this population because he says the state cannot afford to pay for them. 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 rise to the health-reform law's cap of 10 percent in 2020.

All of these possible changes are making farmers unsure of what to expect, said Martin Richards, executive director of the Community Farm Alliance.

He said they are asking questions: "Without Kynect, how many more obstacles will be placed between me and my family and getting health insurance? Will I be able to continue to farm, raise a family without affordable healthcare insurance?"

"Until the Affordable Care Act and Kynect, a whole generation of Kentucky farmers often struggled with getting affordable healthcare, myself included," Richards said. "Somebody had to work off the farm to provide the family with access to health care."

All three farmers who spoke at the news conference attributed their affordable health insurance to the expansion of Medicaid, which covers those with incomes up to 138 percent of the federal poverty level; having access to Kynect, the state's health insurance exchange; and having access to their Kynectors, who have not only helped them choose the best plans for their families, but have also answered their questions and helped them adjust their plans along the way.

Abell said he and his wife, Bree Pearsall, became farmers in 2010 in Oldham County. He said they have had both good years and bad years on the farm and as a result have participated in both private Kynect plans and Medicaid.

"Kynect has provided us with a seamless platform that understands our families' changing economic situation and has been able to offer different insurance plans based on how that farming season has gone," he said.

One advantage of Kynect is that it can help Kentuckians sign up for both federally subsidized policies and Medicaid. The federal exchange only signs people up for policies, so Kentuckians who qualify for Medicaid will have to sign up for it on a different website.

Rae Strobel said she and her husband, Adam Barr, are seventh generation farmers on Barr's family farm in Meade County, and she too had worked off the farm for both income and health insurance in the early years. She said they signed up for insurance the first year it was offered through the ACA, which allowed her to also become a full-time farmer and stay home with their son.

"Adam and I will be the first in three generations to make a living by farming the land full time, assuming that we continue to have access to affordable health insurance," Strobel said.

Strobel sang the praises of their Kynector, who helped them navigate the system and choose a health plan. She noted that their Kynector continues to help them as they face different life-changing events.

"If Kynect is taken away, what will that mean for us?" she asked. "My fears are that it will mean less choice and health insurance options that would work for our family and a system that is not as easy to navigate and most important for us is no help from a Kynector that would guide us through when we have questions."

Bill Wagner, executive director of Family Health Centers in Louisville, told The Courier-Journal that a move to the federal exchange would leave the state with one-fourth as many Kynectors. Glisson estimated at the subcommittee meeting that Kentucky has 500 Kynectors.

Carolyn Gahn said that she and her husband Jacob were a typical young couple that didn't worry about not having health insurance in their 20s, but in 2012 Jacob was diagnosed with a health condition and "our world was turned upside down." They are farmers in Garrard County.

"We were grateful when the ACA was enacted and Jacob was now able to get full coverage regardless of his pre-existing condition," she said.

They have since added two children to their family and she noted how easy Kynect was to update the changes in both income and family size over the years. Her family has been on both subsidized policies and Medicaid.

"With this security we have been able to focus on building our business full time," she said. "Without the support for our health coverage, we would not be financially able to run our own business."

None of the farmers interviewed said they knew much about the federal exchange, but Abell said "Kynect was built by Kentuckians for Kentuckians and it's a Kentucky agency. It is responsible to the needs of Kentuckians."