Pence touts Republican health plan, seeking Sen. Paul's support; Democrats say vice president's remarks about Ky. are off base

Gov. Bevin and Vice President Pence (C-J photo by Sam Upshaw)

By Al Cross
Kentucky Health News

Kentucky again became the epicenter of the health-care debate on Saturday, as Vice President Mike Pence claimed in Louisville that "Kentucky is a textbook example of Obamacare's failures," while Democrats said Pence didn't know what he was talking about.

"Obamacare has failed the people of Kentucky, Obamacare has failed the people of America and Obamacare must go!" Pence told an invited audience of more than 100.

Pence, until recently governor of Indiana, cited rising premiums for federally subsidized policies sold on government exchanges and Louisville-based Humana Inc.'s planned departure from the exchanges, and claimed "Nearly half of the state only has one health insurer to choose from."

That's true only in the number of counties with one Obamacare insurer; most of them are relatively small. Rep. Andy Barr, R-Lexington, defending the Republican replacement bill on CNN after the event, said incorrectly, "Here in Kentucky almost 50 percent of the people have only one choice."

Pence continued, "One-third of the state is on Medicaid, and as your governor has said over and over again, it’s unsustainable. And Medicaid here in Kentucky is threatening to bankrupt this state." For a transcript of Pence's remarks, go to http://kyhealthnews.blogspot.com/p/r.html.

Gov. Matt Bevin, who introduced Pence at the energy-management firm Harshaw Trane, has asked federal officials to let him scale back the Obamacare expansion of Medicaid by his predecessor, Democrat Steve Beshear. President Trump's administration is expected to approve the request.

"As Bevin and Pence were denouncing Obamacare, supporters unleashed a flurry of tweets citing benefits of the law in Kentucky," reports The Courier-Journal's Deborah Yetter. Outside the event, "More than 600 people gathered along the road," The C-J reported. "Many of the protesters chanted, 'Save our care'."

At a press conference after the Republican event, Beshear said the expansion has had a positive impact on the state budget and economy, by funneling billions of federal dollars into the state's health-care system. He said of Pence, "He apparently has decided to join the governor in ignoring the facts about how successful the ACA has been in Kentucky and instead enter the world of alternative facts."

Beshear noted that more than 500,000 Kentuckians gained health coverage under the ACA, and that the state "saw its uninsured population drop from about 20 percent to about 7 percent," James Bruggers writes for The Courier-Journal. "But Kentuckians also voted for Trump, who campaigned on a promise to repeal and replace Obamacare."

"Beshear acknowledged there were problems with parts of Obamacare, such as limited participation by insurance companies in some states or counties," Bruggers reports. "But he said Republican critics caused that by creating too much uncertainty. As a result, he said, some insurers 'are sitting on the sidelines'. He said he'd like the two parties to work together on solving those problems."

Rep. John Yarmuth of Louisville, the only Democrat in the Kentucky congressional delegation, told WHAS-TV, said the Republican bill "would devastate places like Kentucky, which have very poor populations and desperate need for health care."

Yarmuth said in a CNN interview that Obamacare "is definitely sustainable," but "Insurance markets need work." He said he favors allowing people to "buy into Medicare. But I don't get total agreement on that from many people."

Yarmuth said Pence came to put pressure on U.S. Sen. Rand Paul, who has called the Republican health bill "Obamacare lite." Paul said Saturday, "What's going on behind the scenes this week is a charm offensive." Paul will be on CBS's "Face the Nation" Sunday.

Pence didn't mention Paul in his speech, but said, "Now I know that not every politician in Kentucky supports our plan to repeal and replace Obamacare. I know your former governor, Steve Beshear has been defending Obamacare all over America." He called Beshear is a friend with whom he had worked, "but your former governor is wrong about Obamacare."

Pence complimented 2nd District U.S. Rep. Brett Guthrie, R-Bowling Green, for supporting the bill in committee. "We need every Republican in Congress, and we're counting on Kentucky," he said.

First District Rep. James Comer said in a brief interview Saturday that he was leaning toward supporting the bill. Fourth District Rep. Thomas Massie, R-Vanceburg, a Paul ally, told The Washington Examiner that the bill is "a stinking pile of garbage."

Bevin told reporters Friday that he is closer to Paul on the issue. "Senator Paul has ideas; he thinks it needs to be a lot stronger. He's not as impressed with what has currently been offered as some who have currently offered it. Truth be told, I'm not either, so I'm with him. I think there are things that need to be done. We don't need another version of the same thing."

Bevin said the Medicaid expansion "is not working well. It's coming at a price that's unaffordable . . . While we have enrolled a lot of people, we haven't made people healthier, we really have not, nor are we on track to do it, and we're on track basically to break the system."

Bevin has noted that few Medicaid members get regular checkups. On the other hand, a survey of low-income Kentuckians found they had become more likely to say they were in excellent health than their counterparts in Texas, which didn't expand Medicaid. The researchers wrote, "Significant impacts of Medicaid expansion may take several years to unfold."

Bevin also told reporters, "We have rural hospitals that, rather than becoming stronger, have failed since the implementation of this in Kentucky. We have doctors that have given up their practices; some have retired, some have sold out. We have fewer and fewer doctors who are even willing to see Medicaid patients." Bevin's office has not responded to a request for evidence supporting that statement.