Wednesday, February 28, 2018

Big majorities of Ky. adults in both parties want all to have access to affordable, quality health care; 46% say cig tax could pay for it

By Melissa Patrick
Kentucky Health News

Nearly nine in 10 Kentucky adults would like to see all Americans have access to affordable, quality health care, according to the latest Kentucky Health Issues Poll.

The policy found agreement among majorities of all major parties in the state, with 94 percent of Democrats, 87 percent of independents and 81 percent of Republicans favoring access to affordable, quality health care for all Americans.

But wanting everyone to have health insurance and agreeing on how to pay for it is often a topic of great debate. The poll addressed this by asking Kentucky adults how they would fund Medicaid, the federal-state program that provides free health insurance to low-income Kentuckians.

About 1.4 million Kentuckians are on Medicaid, with about 480,000 of them through the 2014 expansion of the program to those who earn up to 138 percent of the federal poverty line under the Patient Protection and Affordable Care Act.

The poll, taken Oct. 24 to Dec. 2, asked: "Suppose the Commonwealth of Kentucky is unable to afford health coverage for everyone who is eligible for the Kentucky Medicaid program. Which of the following options would you most like to see Kentucky lawmakers choose to address this?" The respondents were given six options, including one  "don't know."

Nearly half, 46 percent, said they would increase the STATE tax on cigarettes to pay for Medicaid; 13 percent said they would like to see other state-funded programs cut; another 13 percent said they would reduce the number of adults the program covers; 9 percent said they'd raise the state sales tax; 8 percent chose to raise the state' income tax; 6 percent said they would reduce the number of available Medicaid services; and 6 percent said they didn't know.

Gov. Matt Bevin has often said that Kentucky can't afford to have one-third of its population on Medicaid, a program that consumes about one-third of the state's overall budget. The state House recently released its biennial budget proposal, which has a companion bill that proposes to raise the cigarette tax by 50 cents per pack to help balance the budget.

The poll "is yet another indication that an increased cigarette tax is considerably more popular than any other revenue measure," said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsors the survey. "Any way you ask the question, and we've asked it several ways, raising the tax on cigarettes outstrips other options. We also see from this poll that the public prefers that revenue from a cigarette tax be spent to support Medicaid."

Chandler also chairs the Coalition for a Smoke-Free Tomorrow, which supports raising Kentucky's cigarette tax by at least $1 per pack, to reduce smoking and tobacco-related illness.

The poll also showed that 44 percent of Kentucky adults have a favorable opinion of the Affordable Care Act, the highest rating since the poll began asking this question in 2010, the year the law passed. It also showed a record low percentage who said they disapproved of the ACA, 33 percent. Another 23 percent said they didn't know enough about the law to have an opinion of it.

Meanwhile, Bevin's administration is rolling out its new Medicaid plan, which among other things requires small premiums and for some Medicaid recipients to work,volunteer or take job training 80 hours a week in order to get their health benefits. The administration says the plan will result in the Medicaid rolls having 95,000 fewer people in 2023 than there would have been without it, either through "non-compliance" or by moving them to higher paying jobs that offer private health insurance. The plan is being challenged in court; Bevin has said that if he is not allowed to implement it, he would end the Medicaid expansion altogether.

The poll, co-sponsored with the Cincinnati foundation Interact for Health, surveyed a random sample of 1,692 adults from throughout Kentucky via landlines and cell phones. The poll's margin of error is plus or minus 2.4 percentage points.

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