Study finds 78 percent of Kentucky adults on Medicaid have coverage through expansion, most of them young adults

Medicaid covered almost 636,000 adult Kentuckians in the second quarter of this year, with the great majority of enrollees covered under Medicaid expansion and almost half of them young adults, according to a report done for the Foundation for a Healthy Kentucky.

The report found that 493,199, or 78 percent, of the 635,747 Kentucky adults covered by Medicaid were covered by the Patient Protection and Affordable Care Act's expansion of the program to those who earn up to 138 percent of the federal poverty level. The remaining 142,548 were covered by traditional Medicaid.

Almost half (46.5 percent) of the newly covered expansion population were young adults between 19 and 34, the report says. The same age group comprised the largest portion of traditional Medicaid enrollees.

"Medicaid expansion was most important for younger Kentucky adults," Ben Chandler, president and CEO of the foundation, said in a news release. "This tends to be the healthiest population, but if they lose insurance, they're not likely to take advantage of the preventive care that will help keep them healthier throughout their lives. Moving forward, then, the goal has to be keeping them insured."

That goal may face obstacles if President-elect Donald Trump goes through with his promise to repeal health reform, though now he says he wants to keep parts of it.

Gov. Matt Bevin says the state can't afford to pay for the expanded Medicaid population after Jan. 1, when Kentucky taxpayers will start paying for the expansion: 5 percent in 2017, rising in annual steps to the law's limit of 10 percent in 2020.

Bevin has asked the federal government to let the state require Kentucky beneficiaries to pay monthly premiums and require non-disabled recipients to work or do community service. The proposal says this plan "is expected to save taxpayers $2.2 billion over the five-year waiver period," by reducing enrollment in the program, but only $331 million of that would be state tax money, because the federal government covers the bulk of Medicaid costs. The plan is currently under negotiation with federal officials.

The report on Medicaid enrollment comes from the State Health Access Data Assistance Center at the University of Minnesota, which the foundation is paying more than $280,000 to study the impact of the ACA over three years. This study shows a quarterly snapshot of April, May and June 2016.

The report also found that the distribution of the Medicaid expansion enrollment across Kentucky remained virtually unchanged from the third quarter of 2015, with 30.7 percent in Eastern Kentucky, 25.8 percent in Western Kentucky, 19.6 percent in greater Louisville, 16.4 percent in greater Lexington and 7.5 percent in Northern Kentucky.