Recovering alcoholic built Kentucky's largest substance-use treatment provider, which has 1,800 beds and 1,350 employees

Map from Addiction Recovery Care website, via Kentucky Lantern, adapted by Ky. Health News

By Deborah Yetter
Kentucky Lantern

LOUISA, Ky. — Around the office at Addiction Recovery Care, Vanessa Keeton is still known as “Client One” — marking her status as the first client of the first recovery center ARC opened as a group home in Lawrence County.

But her official title is vice president of marketing, where she has worked since 2012, a little more than a year after she entered the program known as Karen’s House — choosing it over jail for a string of drug and alcohol-related offenses.

Vanessa Keeton
(Lantern photo by Matthew Mueller)

“Dec. 2, 2010, that was my first day,” she said. “That’s a day I’ll never forget as long as I live. That’s the day that everything changed.”

ARC, too, has changed dramatically since it started as a treatment home for women run by volunteers, based largely on Bible study and prayer.

It now operates as a for-profit company paid $130 million last year by Medicaid, the federal-state health plan which in 2014 expanded access to addiction treatment, or substance-use disorder, as it’s now known.

Gov. Andy Beshear has praised ARC for helping Kentucky — ravaged in recent years by addiction and overdose deaths — become the state with the most treatment beds per resident in the nation, according to an East Tennessee State University study.

“With the help of organizations like ARC, we are working to build a safer, healthier commonwealth for our people,” Beshear said, speaking at an ARC ribbon-cutting for a new facility in March.

Owned by founder and CEO Tim Robinson and his wife, Lelia, the company provides the couple an annual income of about $533,400, according to a 2022 tax-filing by Odyssey Inc., a non-profit affiliated with ARC.

Tim Robinson (Lantern photo by Matthew Mueller)

Robinson said he and his wife struggled financially for years while establishing the treatment business — facing potential foreclosure on their home and repossession of their car. He doesn’t think that income is unreasonable.

“We took a lot of risks,” said Robinson, 48, a lawyer and recovered alcoholic who says he has been sober since 2006 — two years before he started building the faith-based treatment business that would become ARC. “I’m living the American dream. I’m doing better than I ever thought I could be doing financially.”

Kentucky’s largest provider

The fast-growing company is by far the state’s largest substance-use treatment provider, with 1,800 residential beds in 24 Kentucky counties, and reaches hundreds more clients through outpatient services. ARC, which estimates it provides 75% of treatment beds in Kentucky, also is planning programs in Ohio and Virginia.

Earlier this year, ARC opened a 40-bed behavioral health unit with plans to expand to 300 at the former Our Lady of Bellefonte Hospital in Ashland, which closed in 2020. In 2020, ARC opened its largest center — with a capacity for 700 — on the campus of St. Catharine College in Springfield, which closed in 2016.

ARC is no longer simply a treatment organization, said Matt Brown, a former ARC client who overcame addiction and now serves as ARC’s chief administrative officer and president of ARC Healthcare. “We view ourselves as a behavioral health system,” Brown said.

While Christian faith remains at the heart of its mission, ARC relies on professional therapists, medical specialists including nurses and doctors, a structured treatment program and medication such as Suboxone to reduce the cravings of some patients for drugs and help them maintain sobriety, Robinson said.

Its religious component — which includes tracking how many clients decide “to follow Christ” (1,320 in 2023) — is strictly voluntary, according to Robinson, who said he was able to get sober in 2006 with the help of a local pastor and friend who “led me to the Lord.”

More importantly, he said, is that the number of clients who agree to stay in long-term treatment up to six months has increased steadily, which he thinks is the best indicator of effectiveness of the program.

Medicaid, which funds the majority of substance treatment, doesn’t require programs to measure outcomes.

But ARC measures its own outcomes, which it reports to Medicaid quarterly, Robinson said. That includes a retention rate of around 70% of its clients in treatment for up to six months and even longer through periodic contact with a case manager.

“I’ve been in this a long time,” Robinson said. “Long-term residential treatment is the reason people recover.”

As an indicator of success in addressing addiction, the Beshear administration points to the decline, for the second year in a row, of overdose deaths in Kentucky.

The state’s latest overdose report, released in June, shows a decrease in deaths to 1,984 from 2,200 the year before, a decline of 9.8%.

Last year, ARC received about $130 million in payments from Kentucky’s Medicaid program — more than double the amount of its closest competitor, Spero Health, a Nashville- based company that received $60 million in Kentucky Medicaid funds in 2023, according to the Cabinet for Health and Family Services, which licenses and oversees treatment facilities and Medicaid.

ARC accepts private insurance, but Robinson and Brown said almost all of the company’s revenue is from Medicaid, since their clients generally have lost jobs and any health insurance because of addiction.

The state spent $1.2 billion on substance-use-disorder services in the fiscal year that ended June 30, 2023, with most funds coming from the federal government, according to the cabinet.

Robinson, a former county prosecutor who started his business from a home office in Louisa, has emerged as a major political donor and well-connected business leader who recently joined the Kentucky Chamber of Commerce board.

Beshear singled out Robinson for recognition in his State of the Commonwealth speech in January, calling him “an essential partner in our fight against addiction.”

Robinson, a lifelong Republican, is effusive in praise for Beshear, a Democrat, in part because of the governor’s emphasis on addiction treatment and the governor’s frequent references to his own religious faith.

“I’ve never been for anybody like I’ve been for Andy Beshear,” Robinson said. “I hope he runs for president.”

‘Treatment on demand’

ARC employs 1,350 people, 500 at its headquarters in Louisa, population 2,600, perched above the forks of the Big Sandy River, across from West Virginia. The company is Lawrence County’s largest employer, even more than the school system.

About 40% of its workers are “graduates” of its treatment program, Robinson said, and most of its upper management — himself included — are in recovery from addiction.

ARC promises “treatment on demand,” and operates a 24-hour hotline people can call to identify help within 15 minutes, including transportation, if needed, to one of its centers. Last year it served more than 12,000 individuals from 119 of Kentucky’s 120 counties.

Tim Robinson in front of one of his buildings in 
downtown Louisa (Lantern photo by Deborah Yetter)

It has developed a network of job-training programs including welding, automotive repair, lawn service, culinary arts, chaplaincy and food service. As part of that, ARC has rebuilt more than a block of rundown buildings in downtown Louisa into a coffee shop, commercial kitchen, community theater and an event space.

It offers clients a chance to get certification toward a trade and get college credit for some training.

ARC owns a pharmacy used to provide medication to clients, a laboratory for medical testing and operates a health clinic in Louisa. Also, Tim and Lelia Robinson founded the private Millard School, a Christian academy in Louisa attended by some children of their employees.

Vanessa Keeton and her husband James live in Louisa and their son attends the Millard School. James, a 2011 ARC graduate, manages the Second Chance garage which repairs and restores vehicles for the public as well as maintaining an ARC fleet of about 200. “We restore cars and we restore lives,” he said.

ARC runs a sophisticated marketing program complete with a website, billboards, television and radio commercials, a social media presence, sponsorships and news releases, contracting with the Louisville-based public relations firm, RunSwitch. Scott Jennings, a CNN commentator and Republican political consultant, is one of RunSwitch’s founding partners. ARC spends about 4.5% of its revenue, or about $5.8 million a year on marketing.

Vanessa Keeton said the marketing is important to promote awareness of its services to those in need, “to meet people where you are.”

‘Dangerously brilliant’?

Some outsiders criticize ARC for its rapid growth, its size and Robinson’s political giving, including Mark La Palme, the founder and former CEO of Isaiah House, a treatment program based in Harrodsburg.

La Palme, now retired, said he worked with Robinson on a project in the mid-2000s but parted ways over disagreement with practices including designating clients as “interns” in ARC programs for low pay while in treatment, saving the company the cost of paying a regular employee.

He calls ARC “huge,” has called it a “bully” in a social media post and questions its rapid expansion. La Palme also questions the prolific giving of Robinson and ARC entities, which rank among the state’s major political contributors.

“It seems like you’re buying political influence,” he said.

But he acknowledges that Robinson has been highly effective in building ARC into the state’s largest treatment system: “He’s dangerously brilliant.”

Robinson said he considered La Palme a friend and colleague but they parted ways after a proposed collaboration fell through. Robinson said ARC’s programs meet all state standards, are accredited and the company works to provide high quality care.

He said internships are a way of introducing people to job skills they will need to succeed once they leave treatment and interns in various job training programs receive a paycheck either through ARC or an outside employer.

Robinson said he doesn’t apologize for political giving, seeing it as a way to support causes and politicians he believes in.

And he doesn’t think ARC is too big, saying that the company had to expand to remain viable within the constraints of Medicaid reimbursement, which pays for most of its clients. “We had to grow to survive,” he said.

The Robinson employees who spoke with Kentucky Lantern, including Brown, are highly enthusiastic about the boss.

Brown, trained as a physical therapist, battled addiction for 18 years before coming to ARC as a patient and remaining as an employee.

Robinson is “a visionary,” Brown said during a tour of ARC properties in Louisa, “He sees things in people before they see it in themselves.”

‘Papaw taught me’

Robinson said he grew up in adjoining Martin County, in “the poorest part” of a poor county. His introduction to business came from his grandfather who owned a country store. “He put me on a pop carton to run the cash register,” he said. “Papaw taught me about business.”

Another boyhood business venture of Robinson’s — selling baseball cards — would provide a life-changing entrée into college and law school, when he was befriended by Inez banker and businessman Mike Duncan, a former Republican national chairman and mentor to many young people in Martin County.

Robinson said he and Duncan crossed paths when he began selling baseball cards to Duncan's son, Robert M. “Rob” Duncan, who was appointed U.S. attorney for Eastern Kentucky under Donald Trump. Duncan is now the top deputy to state Attorney General Russell Coleman.

Robinson said he considers both Duncans friends but remains closest to Mike Duncan, a trusted friend and adviser. He said Mike Duncan, showed interest in his boyhood baseball-card venture and became a mentor, encouraging Robinson to go to college — a prospect he hadn’t considered.

“Nobody in my family ever went to college,” Robinson said.

But with Duncan’s encouragement, Robinson graduated from the University of the Cumberlands in Williamsburg, earned a law degree from the University of Kentucky and was elected student body president at both institutions.

Good times and bad times

“He helped me through the good times and the bad times,” Robinson said.

Among the worst times: Robinson’s 2003 indictment for felony vote fraud while he was student body president at UK, after some 750 voter registration cards collected during a student government drive were never turned in. Apparently forgotten, they were later found in a student-government office, according to a 2003 Lexington Herald-Leader story.

“It was devastating,” Robinson said. “I thought my whole life was over.”

Instead, with the help of his lawyers, Robinson pleaded guilty to a lesser misdemeanor charge of failing to turn in the registration cards and paid $90 restitution. Robinson said he dropped out of law school during the legal case, but was readmitted and graduated.

But that ordeal, plus the death of his mother while he was at UK, “finished my mental health off,” Robinson said. He returned home to Eastern Kentucky to work but alcohol by then had a powerful hold on his life.

Back in Lawrence County, Robinson joined in law practice with a friend and became an assistant county attorney but by then said he had become a “raging alcoholic” though still somehow able to perform his job.

He would drink on weekends, come to work on Mondays hung over and avoid alcohol on days he had to be in court. Toward the end of the week, Robinson said, he’d resume drinking and stay drunk till the following Monday. “I was leading kind of a double life,” he said.

That continued until a deputy sheriff at the courthouse where Robinson worked intervened. The deputy, also a pastor and a recovering alcoholic, helped Robinson stop drinking through prayer and support — taking him with him to nightly events where he would preach and play Bluegrass music.

Though Robinson said he knew nothing about treatment or programs such as Alcoholics Anonymous, he decided he needed to expand services in the region that in the mid-2000s offered little.

“I was convinced God was calling me to stop practicing law and start a recovery center,” Robinson said.

So he did, leaving his law job and starting out of a home office on Nov. 3, 2008.

Robinson got help from Rev. Ralph Beiting, a Catholic priest who founded the Christian Appalachian Project. Together they opened a recovery house for women in Lawrence County called Karen’s House.

It was a makeshift operation run by volunteers with donated goods, including some old Army cots. Meanwhile, Robinson was taking men to the closest treatment center, Chad’s Hope in Clay County, getting occasional funding from Operation UNITE, launched in 2003 by U.S. Rep. Hal Rogers to help Kentucky battle rising addiction — in particular the tide of opioid pain pills engulfing the state.

But broke and discouraged, Robinson was close to quitting when he contacted a consultant who suggested he expand by opening a second recovery center for men. He located a site in Fleming County and in 2013, Belle Grove Springs was opened by the company that would become ARC.

Brown, now ARC’s chief administrative officer, was among the first clients admitted to the men’s center.

The following year, under the expansion authorized by the Patient Protection and Affordable Care Act, Medicaid began funding substance use disorder services and a reliable funding stream opened. Kentucky was among the first states to include addiction as a service covered by Medicaid.

While the income was welcome, it wasn’t enough to finance ARC’s operation and Robinson said the company’s only choice was to expand and recoup more money through a higher volume of clients. “People thought we were growing because we were booming but we had to grow to survive,” he said. “You cannot make it on a couple of small facilities.”

ARC didn’t show a positive cash flow until 2019, he said.

‘Take our time’

While ARC expansion has slowed, Robinson said the company is still looking at other opportunities, including expansion into Virginia, which has far fewer treatment beds than Kentucky. “We’re going to take our time,” he said.

ARC also was flagged in a budget item this year by the state General Assembly with a $12 million allocation over two years directed to the Life Learning Center in Covington, an organization aimed at helping people develop skills to improve their lives “through gainful employment.”

The budget line says the funds are to be distributed to the center to support “treatment, rehabilitation, and community reintegration in partnership with Odyssey Inc.,” the non-profit arm affiliated with ARC.

Robinson said he expects Odyssey to submit a proposal as treatment provider for a program the center plans to establish in Somerset.

And while his work has expanded statewide and beyond, Robinson said he’s committed to staying in Louisa and keeping his company headquartered there.

“I’m where I’m going to be,” he said. “This is my adopted hometown.”

Drug-overdose deaths of Kentuckians fell 9.8% last year, but rate among state's Blacks increased 5%; overall U.S. decline was 3%

Graph by Kentucky Health News from state data

By Al Cross
Kentucky Health News

In 2023, 9.8 percent fewer Kentuckians died from drug overdoses than the year before, according to an annual state report released Thursday.

A preliminary report from the Centers for Disease Comtrol and Prevention last month showed a 7.9% decrease, but the CDC now includes deaths of non-residents. The state Office of Drug Control Policy says in the state report that it uses only resident deaths "to better target harm reduction and prevention activities for Kentuckians." 

The state report was funded by the CDC and prepared for the office by the Kentucky Injury Prevention and Research Center at the University of Kentucky, as an agent for the state Department of Public Health.

It said 79% of the overdose deaths involved fentanyl, a powerful synthetic opioid, and 55% involved methamphetamine, a stimulant with psychedelic properties. The numbers are based on blood tests of victims, who usually have more than one illegal drug in their bloodstream.

“Fentanyl is what’s driving this crisis. If we could ever get a handle on that I think out potential for success is unbelievable,” Van Ingram, director of the drug-control office since 2004, said at an event in the state Capitol rotunda attended by people from the treatment, recovery and law-enforcement communities.

Gov. Andy Beshear told the crowd, “Some of the best news in this report is how much better than we were than the rest of the country,” in which overdose deaths declined 3%, according to the CDC. “Today’s news follows a long list of positive actions we have taken with so many people in this room,” he said.

Earlier, Beshear said, "The sad fact is we still lost 1,984 Kentuckians." That is about the same as in 2020, and much more than 2019. And he noted that overdose deaths among African American residents of the state rose 5% in 2023, from 259 to 264, after rising 22% from 2021 to 2022. While the recent increase was much less, "That is unacceptable," he said.

The rate of drug overdose deaths among Black Kentuckians in 2023 was 68.3 per 100,000, which was 52% greater than the white rate of 45 per 100,000.

The age group with the most overdose deaths was 35-to-44-year-olds, with 571, but the number was 13.4% less than in 2022.

In that year, 2,135 Kentuckians died of drug overdoses. The decline of 9.8% “represents 151 families whose loved ones still have a chance to recover,” said Dr. Jody Jaggers, the Kentucky Pharmacy Education and Research Foundation's director of public health education.

Jaggers demonstrated how easy it is to use naloxone, which stops the effect of an overdose. "It's something that you can even teach a child to do," he said.

Known by the brand Narcan, the nasal spray is now easily available in generic form without a prescription. Jaggers said the key is getting it into the hands of people who are most likely to witness an overdose. 

The report says the state distributed 160,000 doses of Narcan in 2023, and Ingram indicated that the increased availability of naloxone was a factor in the 9.8% drop in overdose deaths. The state recently put up a website, FindNaloxoneNowKY.org, to help Kentuckians find it easily.

Among counties with 10 or more overdose deaths, for which overdose-death rates were calculated, the highest rates were in four counties that adjoin each other. Estill County had 27 overdose deaths for a top rate of 187 per 100,000 residents; second was Lee County, with 11 deaths for a rate of 155.9. Third was Breathitt County, which had 18 for a rate of 150.6. Fourth was Powell, which had 16 for a rate of 121.1. Fifth was Floyd, which nearly adjoins Breathitt; it had 35 deaths for a rate of 109.9 per 100,000.

Other counties with rates higher than 60 per 100,000 (in purple on the map below) were Bourbon, 85.9; Boyd, 94.2; Carter, 90.4; Clark, 72.9; Clay, 68.9; Franklin, 61.9; Garrard, 61.9; Jefferson, 66.3; Knott, 100; Lincoiln, 76.4; Madison, 72.1; Montgomery, 62.8; Perry, 93.3; Pike, 74.5; Rockcastle, 91.8; Rowan, 94.9; Wayne, 59.8; and Whitley, 59.3.

Counties with rates lower than those, but higher than the state average of 45.9 per 100,000, were Bell, 50.7; Boyle, 56.8; Bullitt, 51.6; Harlan, 57.3; Jessamine, 56.2; Johnson, 59.3; Laurel, 54; and Taylor, 50.1.

Map from state report, adapted by Kentucky Health News

Despite waiting list, a shortage of nurses and plenty of money, governor and legislature don't fund new building for KSU nursing

Kentucky State University’s nursing program has outgrown the Betty White Health Center, opened in 1971. Nursing classes are spread in buildings across campus. (Kentucky Lantern photo by Jamie Lucke)

By Sarah Ladd
Kentucky Lantern

Kentucky State University requested $50 million this year to build a nursing school for its growing class of future health care providers. The governor and legislature rejected the request, even though the KSU program has a waiting list and Kentucky suffers from a shortage of nurses but enjoys a record surplus.

“The real tragedy is that we had the money to do it,” Rep. George Brown Jr., a Lexington Democrat, told the Lantern last week. He called the omission “a travesty.” Brown and other lawmakers said the decision is part of a long pattern of neglect and underinvestment in historically Black colleges and universities (HBCUs) — a disparity the Biden administration also has highlighted.

It’s “always been the history,” said House Democratic Floor Leader Derrick Graham, a KSU alum who urged Republican legislative leaders to fund the nursing building.

During House debate, Black lawmakers pointed out that Kentucky’s only public HBCU was being denied $50 million for a project they deem critical to its future, while $125 million was quickly found for Northern Kentucky University and the University of Kentucky to open a biomedical center in downtown Covington, where plans also call for NKU to move its law school.

The Senate added the Covington project to House Bill 1, which moves $2.7 billion from the Budget Reserve Trust Fund into one-time spending over the next two years. HB 1 includes other higher education projects: $60 million for a veterinary tech facility at Murray State University, $25 million for a UofL Health cancer center in Bullitt County and $22 million for a livestock innovation center at a UK research farm.

“Kentucky State always seems to suffer and always has to wait,” Brown said March 29 on the House floor. “‘You have to wait your time; it’s not your time.’ … So the question is, when will it be Kentucky State’s time?”

When budget negotiators met in a free conference committee on March 26, Graham asked why KSU’s “top priority” was not included in budget legislation. Graham represents Frankfort where KSU sits on a hill overlooking the capital city. Sen. Chris McDaniel, chairman of the Senate budget committee, said KSU had also revised its budget request by asking for money to deal with failing infrastructure and other maintenance needs.

House Bill 6, the budget bill, sets aside $60 million in bonding for “asset preservation,” described by McDaniel as “cleaning up campus.” House Bill 1 includes $5 million to design a Health Science Center for the nursing program but nothing to build it. McDaniel vowed “full intent” to pay for construction of KSU’s nursing building in the 2026 budget bill. McDaniel’s district includes Covington; he was instrumental in obtaining the $125 million for the downtown project involving NKU.

“We have a great deal of confidence in the new president of Kentucky State,” McDaniel said in the March 26 meeting. He was speaking of Koffi Akakpo, who became KSU’s 19th president last year on July 1. Before that, he was president of Bluegrass Community and Technical College.

HB 6 provides all the public higher-ed institutions with asset preservation funding pools for renovation and maintenance of buildings and other infrastructure.

During the free conference committee meeting, Democratic Senate leaders Gerald Neal of Louisville and Reggie Thomas of Lexington, both of whom are Black, said that expanding KSU’s nursing program is critical to the school’s rebound from recent troubles. The construction delay will cost KSU new students and needed tuition revenue and disrupt Akakpo’s plan for the future, said Neal.

Neal and Thomas urged the budget negotiations to reconsider. Thomas suggested spending less on restoration and maintenance at KSU in this budget to free up $50 million over the next two years to design and build the nursing building.

Senate Republican Floor Leader Damon Thayer of Georgetown responded ​​that KSU was “probably lucky that they get the taxpayer money that they have been getting and continue getting. With the recent numbers and results that have come from K-State, I think we should be dubious moving forward.” He said the “numbers have been pretty embarrassing.”

KSU has faced a series of controversies, including misused funds under a former administration and a 2023 warning from its accreditation body. In 2022, the legislature put KSU under a management improvement plan and provided $23 million to help it recover from a budget deficit.

In an interview with the Lantern last week, Akakpo said he is “grateful” for the $60 million in bonding but that it will “go quickly” as he tackles a list of maintenance needs.

The HVAC system, he said, is “not quite up to par” and the dorms are “in really bad shape.” Sidewalks and entryways need fixing, he said, and “leaky roofs” have caused damage that needs attention. The $60 million does “not quite” cover these needs, he said. “But we will try the best we can.”

A new building for nursing students and money to address maintenance needs were “both equally crucial for us to move forward,” Akakpo told the Lantern.

KSU's 342 nursing students make up 24% of the university's enrollment, and the program is “only going to grow,” said Akakpo. Nursing students study in three separate buildings because no designated building is large enough.

The Betty White Health Center, which is 53 years old, has administrative offices and a learning lab. Students take classes in Bradford Hall, Carver Hall and Hathaway Hall. “The building is needed because the building that is assigned to the nursing program is too small,” Akakpo said. It’s also already full.

Kentucky is thousands of nurses short of what it needs. The state is short 5,391 registered nurses and licensed practical nurses, according to the Kentucky Hospital Association. And, the students going into nursing school aren’t enough to replace those retiring and leaving the workforce.

Brown said KSU’s backlog of maintenance needs stems from historic underinvestment. The historically Black university, he said, is “the redheaded stepchild, if you will” of Kentucky higher education.

The Biden administration last year documented roughly $12 billion in underfunding for HBCUs nationwide when compared with state funding of similar predominantly white institutions.

The study compared land-grant institutions created by Congress in the 19th century, first for white students and later for Black students. KSU and UK are Kentucky’s land-grant universities. In Kentucky the disparity in per student state funding from 1987 to 2020 was $172 million.

U.S. Education Secretary Education Miguel Cardona and Agriculture Secretary Tom Vilsack sent letters to governors, including Kentucky’s, asking for states to right the “historical underinvestment.”

A letter from Cardona to Gov. Andy Beshear cited “unbalanced funding” and “longstanding and ongoing underinvestment” as reasons KSU “has not been able to advance in ways that are on par with University of Kentucky.” It added that “unequitable funding” of KSU put it $172.1 million short of what it would have received in the last 30 years.

The budget Beshear introduced in December did not include money for the KSU nursing building. It did ask lawmakers to allocate about $1.2 million to KSU for nursing and social-work scholarships in 2024-26.

Republicans talk about making Obamacare better, not repealing it, so it is 'becoming a politically untouchable part' of the safety net

Washington Post graph from Kaiser Family Foundation polling data

Kentucky Health News

"A law once derided as 'Obamacare' and demonized as a big-government power grab is becoming a politically untouchable part of the American safety net, like Social Security and Medicare before it," writes Dan Diamond, lead health reporter for The Washington Post.

As evdience, Diamond cites President Joe Biden's "celebration" of the Patient Protection and Affordable Care Act as he runs for re-election, and former president Donald Trump's "grudging acceptance" of the 2010 law: he no longer wants to repeal it, just "make it better."

In Kentucky, where then-Gov. Steve Beshear embraced Obamacare by expanding Medicaid to the point that it covers every third person in the state, Republicans have realized its political appeal and have not pushed to replicate the failed efforts of Republican Matt Bevin, governor in 2015-19, to impose work requirements on Medicaid beneficiaries.

Nationally, "More than 45 million people now rely on the ACA and its provisions for health coverage, according to a federal report released last week, and the law’s protections for people who have pre-existing conditions have transformed many Americans’ experience of health care. Yet for nearly a decade, Republicans like Trump successfully ran on pledges to 'repeal Obamacare' — and Democrats sometimes ran from it, scarred by the law’s bumpy rollout, the constant political attacks and the struggle to communicate its benefits," Diamond notes. "But when Trump and his Republican allies nearly repealed the ACA — falling one senator short in July 2017 — it sparked passionate efforts to defend it and catalyzed new, long-lasting support."

Between the time Trump was elected and took office, outgoing Health and Human Servcies Secretary Sylvia Burwell "rolled out a 70-day crash plan to shore up support for the health law, developing targeted maps to show members of Congress how the law was affecting their communities," Diamond reports. "She worked the phones to reach GOP lawmakers and governors, seeking promises that they would not cut the protections for people with pre-existing conditions — one of the most beloved parts of the law, and one of the most integral. Burwell knew preserving that provision would complicate the ability to repeal the broader ACA. . . . Ultimately, Sen. John McCain (R-Ariz.) blocked the repeal in a dramatic late-night vote," killing a so-called "skinny repeal" bill sponsored by Republican Leader Mitch McConnell of Kentucky.

As Sen. Mitch McConnell watched, Sen. John McCain turned thumbs down and voted "no" on the bill.

"Today, more Americans than ever have health coverage, with about 21 million insured through the ACA’s private health plans, up from 12 million when Biden took office, according to a federal report released last week," Diamond reports. "Another 23 million gained coverage through the law’s expansion of the Medicaid program."

State Senate restores most Medicaid cuts made in the House

Dr. Bill Collins treats a patient at the Red Bird Mission dental

clinic in Clay County. The Senate budget would increase

dentists' Medicaid fees. (Ky. Lantern photo by Deborah Yetter)

By Deborah Yetter

Kentucky Lantern

The state Senate has largely eliminated cuts to Medicaid that were proposed in the House budget. A top state official had warned the House plan would create a hole next year in the federal-state health plan that covers 1.5 million low-income Kentuckians, a third of the state's population.

“We are pleased that the Senate’s proposed budget restores funding to Medicaid so patients can continue to access the necessary health care services they’re accustomed to,” said a statement from the Cabinet for Health Services, which manages the $15 billion a year federal-state program.

Cabinet Secretary Eric Friedlander appeared before the Senate Appropriations and Revenue Committee last month, along with John Hicks, budget director for Democratis Gov. Andy Beshear, asking the Republican-majority Senate to consider restoring the funds the House cut for the fiscal year that begins July 1.

“This creates a hole in the Medicaid budget for Fiscal Year '25,” Hicks told the committee.

Advocates worry the House plan could force cutbacks in Medicaid services through more than $900 million in cuts to the amount sought by Beshear.

Republicans generally have expressed support for the Medicaid program that pumps money into hospitals, clinics, pharmacies and other medical services throughout the state—with 70% to 80% of the funding provided by the federal government. But some have expressed concern it has grown so large.

The Kentucky Center for Economic Policy told the Lantern last month that overall, the House plan cut about $139 million in state funds Beshear sought for Medicaid in fiscal 2025, which would cause the state to forfeit another $783 in federal matching money, for a total of around $922 million.

The Senate moved its budget bills through committee and to a final floor vote on Wednesday. Dustin Pugel, policy director for the center, said Thursday it appeared the Senate had restored most of the funds but made some cuts including a reduction in “waiver programs” for people with disabilities.

The House plan included about $200 million — about $143 million of that in federal funds — for 2,550 new slots in Medicaid “waiver” programs such as "Michelle P." that provide housing, therapy or other supports for people with disabilities.

Thousands of people are on waiting lists for such services, which generally have been increased by only 50 or so each year.

The Senate version reduces the number of slots over the next two budget years to 1,925.

The Senate did not fund proposed “mobile crisis units,” which were also left out of the House budget. They would provide an alternative to police intervention when someone is experiencing a mental-health crisis.

But the Senate did include an increase in Medicaid payments for dental services, which oral-health advocates say is urgently needed to attract more dentists to the program in a state with high rates of dental disease.

Overall, Pugel said, the Senate plan is “good news for the Medicaid budget.”

However, the budget process is far from over. The House will consider the Senate changes, and if it disagrees, as is usually the case, the budget will bedecided by a House-Senate conference committee.

On 4th anniversary of Ky.'s first Covid-19 case, Beshear says it's a time 'to say that we're going to try to do better and better . . . '

Gov. Andy Beshear spoke at the observance of the fourth anniversary of Kentucky's first case of Covid-19. Next to him are Health Commissioner Steven Stack, in the front row, and Kandie Adkinson, in the back row. At the end of the front row are Rowena Holloway, widow of Virginia Moore, who was Beshear's main sign-language interpreter during the pandemic, and LeRoy Mitchell, who talked about his near-death from the disease and his sister's death from it. (Lantern photo by McKenna Horsley)

By Sarah Ladd
Kentucky Lantern

Four years after the day that Kentucky confirmed its first official case of Covid-19, Kandie Adkinson rang a singular bell in the state Capitol rotunda, its chime echoing through the marbled halls.

She did this to honor those lost to Covid-19, just as she did during much of the pandemic.

Adkinson was joined Wednesday by Gov. Andy Beshear and others who gathered in the rotunda to mark the day with grief for those lost to the virus and hope for the future.

In the last four years, nearly 20,000 Kentuckians have died with Covid-19. Many more contracted the illness and survived, like LeRoy Mitchell.

“Most of us know somebody that died because of Covid,” said Mitchell, who drives a bus for the Clark County school system.

His sister died with the virus on Sep. 5, 2020.

“If losing my sister was not devastating enough for me and my family,” he said, “four months later, Covid came for me in the worst kind of way.”

His wife discovered him on Jan. 8, 2021, he said. He was unresponsive and sent to the Clark County Regional Medical Center via ambulance then by helicopter to the University of Kentucky hospital’s intensive care unit in Lexington.

When he got there, he said, he “had no time to spare.” His doctors later told him Covid-19 had caused his diabetic coma and the blood clot in his lung, and was “trying to shut down my kidneys.”

He went on oxygen and spent three weeks in the hospital, followed by rehabilitation for two weeks. He grew weak in the hospital, losing 50 pounds during his ordeal.

“I … basically went back to being like an infant, baby stage. I could not do anything for myself,” he said. His road to recovery — complete with a wheelchair, walker, oxygen tank and supportive wife — took eight months, he said.

Ultimately, Mitchell told those gathered Wednesday, “Covid lost. And I won with life.”

Beshear signed a proclamation Tuesday making March 6 a “Day of Compassion.”

In the future, he said, “we want to, as much as we can every year, not just talk about the loss — and loss is important — but also talk about what good can come out of it?”

“While we don’t face a pandemic, we still face challenges right now. And if we could just approach them with a little bit of the same, at least, attempt to understand each other and love each other, then this world could be a much better place.”

March 6 should be a time to reflect, he said, “where we always say that we’re going to try to do better and better and better as the years go by.”

Beshear lieutenants tell Senate that the House didn't budget enough for Medicaid, based on enrollments they have projected

By Deborah Yetter
Kentucky Lantern

The state Senate began its review of the House two-year budget proposal Feb. 14, starting with Medicaid, which spends $15 billion a year to provide health coverage and other services to about 1.5 million Kentuckians who are low-income, disabled or meet other criteria.

The Senate Appropriations and Revenue Committee heard from Eric Friedlander, secretary of the Cabinet for Health and Family Services, and John Hicks, budget director for Gov. Andy Beshear — chiefly about their concerns over cuts in the state’s share of the program that gets 70%' to 80% of its money from the federal government.

Health Secretary Eric Friedlander said the best way to cut Medicaid

rolls is to attract better-paying jobs with health coverage. State Budget

Director John Hicks is at his right. (Kentucky Lantern photo by Deborah Yetter)

“This creates a hole in the Medicaid budget for Fiscal Year '25,” which begins July 1, 2024, Hicks told the committee. He said the House’s proposed budget for FY 2026 does not cut Medicaid.

Advocates worry the House plan could force cutbacks in Medicaid services in FY 2025 through more than $900 million in cuts to the amount sought by Beshear, a Democrat, in his budget proposal.

Republicans, who firmly control both chambers of the General Assembly, will enact the final budget.

Jason Bailey, executive director of the Kentucky Center for Economic Policy, told the Kentucky Lantern that overall, the House plan cuts about $139 million in state funds Beshear sought for Medicaid in FY 2025, which would cause the state to pass up, another $783 million in federal matching money for a total of around $922 million.

Rep. Jason Petrie (R-Elkton), chairman of the House budget committee, has said the House presumes fewer people will be enrolled in Medicaid, now that the federal government is requiring enrollees to recertify annually that they are eligible. That requirement was dropped during the public health emergency of the Covid-19 pandemic.

But Hicks said state budget forecasters worked hard to project how many people will leave Medicaid—so far, around 200,000—and develop an accurate count for the governor’s budget proposal. “We’ve incorporated those numbers into the budget forecast,” he said.

Advocates are hopeful the Senate will restore the state’s share of funds for Medicaid.

Committee members made few comments as they listened to the Beshear administration officials.

Sen. David Givens, R-Greensburg, expressed concern about the growth in Medicaid, which covers about a third of Kentuckians, including more than a half million children and most nursing-home residents.

Givens asked how to reduce the number of Kentuckians enrolled in Medicaid. Friedlander said most adults who are in the prohgram and not disabled or elderly are working at low-wage jobs without health insurance.

“Getting higher-wage jobs, that’s the way that you work on having fewer people eligible for Medicaid,” Friedlander said. “I think that will make as big a difference as anything else.”

Givens suggested a committee meeting during the interim after the legislative session ends to discuss specific ways to reduce the Medicaid rolls, noting that Medicaid has grown significantly during his 15 years as a legislator. The big jump was in 2014, when the state expanded it under the 2010 Patient Protection and Affordable Care Act to households with incomes up to 138 percent of the federal poverty threshold.

As blood runs short in Ky. and the U.S., Red Cross seeks donors

Gov. Andy Beshear and first lady Britainy Beshear listen to Steve Cunanan, regional CEO of the American Red Cross, as they prepared to donate blood in the state Capitol rotunda. (Photo by Al Cross)

By Al Cross

Kentucky Health News

Responding to a potentially dangerous shortage of blood, Gov. Andy Beshear and his wife set an example Monday by donating blood in the state Capitol and hosting a blood drive in the Capitol Education Center.

First lady Britainy Beshear said before they donated that the number of blood donors in the U.S. is at a 20-year low. Steve Cunanan, regional director for the American Red Cross, said that means the organization is getting 40 percent less blood than usual. It declared a national emergency last month.

Cunanan noted that blood is a perishable product, and is needed an average of every two seconds in the U.S., and only 3 percent of Americans donate blood.

The governor said the shortage could lead to delays in surgeries in Kentucky and would become even more dire in the event of a disaster. He said he and his wife have become regular donors in recent years.

The Red Cross is coordinating with the Kentucky Blood Center, the largest blood bank in the state. Its website has a page where you can enter your ZIP code to find drives in Eastern and Central Kentucky, including Louisville. The Red Cross has a site where you can find blood drives anywhere in Kentucky or the U.S.

Beshear wants 15 medical conditions added to medical-cannabis law, but key legislators say now isn't the time to do that

Conditions in white are authorized by the state law that takes effect in 2025; those in green or yellow are also authorized by Gov. Andy Beshear's order, issued under his pardon power over a year ago.

By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear wants 15 more health conditions to be added to the list of qualifying conditions in the state's legislatively authorized medical-marijuana program, set to take effect in 2025.

Beshear said Thursday that he was making this recommendation along with the Board of Physicians and Advisors and the Team Kentucky Medical Cannabis Workgroup, which on Dec. 21 sent separate letters to legislative leaders recommending the changes be made in the 2024 session.

The list of recommended qualifying conditions should include ALS or Lou Gehrig’s disease, Parkinson’s disease, Chron’s disease, sickle cell anemia, cachexia or wasting syndrome, neuropathies, severe arthritis, fibromyalgia, muscular dystrophy, Huntington’s disease, HIV, AIDS, glaucoma and terminal illness. And, he said, one of the groups has recommended hepatitis C to be added to that list. 

"They are included in most other states' programs, they are very serious conditions that we believe, but more importantly, these medical groups and advisory groups all unanimously agree should become a part of the program," Beshear said Thursday at his weekly press conference. 

The eligible conditions in the current law, passed by the legislature in 2023, are cancer, multiple sclerosis, muscle spasms or spasticity, chronic pain, epilepsy, chronic nausea and post-traumatic stress disorder.

Expanding the list would allow an estimated 437,000 more Kentuckians to benefit from the program, said Beshear.

"This is 437,000 Kentuckians that are suffering from or dealing with the conditions that we just showed up there that are not currently eligible, very serious conditions that would then become eligible for this program," he said. 

However, key legislators told Bruce Schreiner of The Associated Press that the request to expand the number of eligible conditions in the program would have trouble getting out of wither legislative chamber.

Sen. Stephen West, R-Paris, told AP that in passing his bill to legalize medical cannabis for some conditions in 2023, the lawmakers "went back and forth" before reaching consensus on which conditions would qualify. 

“I think there will be much consternation if we start tinkering with the list of conditions it covers,” West told Schreiner.

Rep. Jason Nemes, R-Middletown, a long-time supporter of medical cannabis, agreed.  "I don't think now is the time to make those adjustments," he told Schreiner. 

Beshear and Sam Flynn, executive director of the Kentucky Medical Cannabis Program, said they were talking to legislators  about some of the technical changes needed in the bill and their request to add the additionally recommended qualifying conditions. 

"We've had some productive conversations, particularly with . . . Senator West," said Flynn. "We feel really good about those conversations. As the governor mentioned, there are some some technical changes that we're looking for Senator West and others to take a look at, as well as now expanding the the qualifying conditions based on the recommendations made by both the Board of Physicians and Advisors and the Team Kentucky Medical Cannabis Workgroup." 

Beshear added that the law gives the Kentucky Cannabis Center at the University of Kentucky unilateral power to add conditions, but "They've told us that they don't want to do it." 

"And, if that's the case, we need to make a change in the law," he said. "Now, their position might change. It's the legislative session, and they'll have to look at legislators and say that they've told us they don't want to do it. So we want to make sure that we're transparent about . . . things that they can add while they're here or the legislature can empower a different group. They created that group of doctors and other medical professionals that have suggested this. I mean, our recommendation to them is give that group the power to expand. I mean, that's both under the legislation they created, they created how the board is made up and that will seem like a logical place to go." 

In November 2022, Beshear issued an executive order allowing Kentuckians who meet a detailed set of requirements to possess up to 8 ounces of marijuana for medical use. The drug must to be bought in a state where sale of cannabis is legal, and the person needs the receipt and a certification from a health-care provider saying that they have at least one of 21 specific conditions. Beshear's order is in the form of an advance, conditional pardon.

Beshear said Thusday his administration has 10 new regulations to say how medical-cannabis businesses, including cultivators, processors, producers, dispensaries and safety-compliance facilities, will operate in the state. 

“These regulations will ensure that Kentucky’s medical cannabis program is safe and accessible for all patients and to make sure that they are secure for our communities,” he said.

The governor also announced a partnership with Tyler Technologies and Metric to help establish the medical cannabis electronic monitoring system and patient/caregiver registry. And, he said, the state has launched an online zoning tool to help medical cannabis businesses determine where they can operate. 

Beshear wants lawmakers to be empathetic on controversial issues like abortion; sees better health for Ky. as possible legacy

Gov. Andy Beshear during his interview with Kentucky
Health News in the Capitol's State Reception Room

By Melissa Patrick
Kentucky Health News

In an interview Wednesday with Kentucky Health News, Gov. Andy Beshear said he would be pleased if one of his legacies as governor was improving the health of Kentuckians, and looked forward to the upcoming legislative session.

Beshear acknowledged that if Kentucky has clearly improved its health status when his term ends in 2027, he would have to share that legacy with his father, Steve Beshear, who expanded Medicaid coverage in Kentucky to 600,000 people when he was governor from 2007 through 2015.

"I'd love for both Beshears to be remembered for that," he said. 

Beshear's comments came after he was asked why he thought Kentucky showed a slight upward trend in the latest America's Health Rankings by the United Health Foundation.

The foundation ranks Kentucky 41st for overall health, up from 43rd in the last two rankings (2022 and 2019; the rankings were not made in 2020 and 2021 due to the pandemic). The state was 45th in 2018, 42nd in 2017, 45th in 2016, 44th in 2015 and 47th in 2014.

Beshear said increasing access to health care has been key to improving the health of Kentuckians, not only as a way to improve the quality of their lives, but  as a way to improve the state's workforce. 

"I believe that we are doing better, and that we will do better for a couple of reasons," he said. "First, especially coming out of the pandemic, we are seeing expansion of health-care access all over Kentucky." 

As examples, he pointed to the first hospital being built in West Louisville in 150 years, the expansion of the Bullitt County hospital and the new clinic that  Morehead-based St. Claire HealthCare is building in Morgan County. He said health-care systems are "recognizing that the overall health of our people is a shared responsibility." 

Other examples, "especially over the last four years," he said, are "the leaps we have made in treating addiction, especially the number of treatment beds." He said Kentucky has the most treatment beds per person in the country, and that has improved the overall health of Kentuckians. 

"That's a big start towards getting people healthy," he said. 

Beshear agreed that his father's 2014 expansion of Medicaid to people who earn up to 138 percent of the federal poverty level, under the 2010 Patient Protection and Affordable Care Act, has played a key role in improving access to care. He noted that his administration has extended post-birth Medicaid coverage from 60 days to 12 months, and expanded dental, vision and hearing benefits.

Outcome-based payments? Looking forward, Beshear said it will be important to find a way to use "significant dollars" to incentivize and reimburse Medicaid providers who have good patient outcomes, as opposed to the current model of reimbursing them only for the care they provide. 

"How do we create the best platform and structure to make this happen?" he pondered. "And that's going to be what we're looking at, really closely. . . .  Again, if we can move towards a model where we reward outcomes, I think we can do significantly better." 

Beshear also spoke about the importance of preventive screenings as a way to improve health outcomes, pointing to Lt. Gov. Jacqueline Coleman's experience as an example of their importance. Coleman recently underwent a double mastectomy after concerns were raised during a routine physical examination. 

"That shows just how critical and important that is," he said. 

Legislative issues: When it comes to controversial health issues, like "red-flag" laws or abortion, Beshear said it's important to approach these topics from a place of "basic human empathy" where people can find common ground.  

Beshear said he supports a red-flag law, which allows temporary confiscation of an individual's firearms if a judge finds that person is a risk to themselves or to others. A bipartisan bill to enact a version of the law is planned for introduction in the General Assembly session that begins Tuesday, Jan. 2.

But first, the governor said, he would like to stop the auctioning of murder weapons to the highest bidder. He said his support for such laws has grown stronger since the loss of a close friend, Tommy Elliott, in a mass shooting at the Old National Bank in downtown Louisville. 

"I know what it's like to lose a very close friend in a mass shooting," he said. "I know what it feels like to have someone who you love and care about murdered and taken from you." 

Beshear said it is imperative for the legislatuire to add rape and incest exceptions to the state's near-abortion ban, along with an exception for non-viable pregnancies. 

"There are kids right now that have been raped and impregnated by family members that don't have any options," he said. "Hadley said it right, she wasn't the first and she wasn't the last. There are Hadleys out there right now and they deserve better." 

Hadley Duvall, who was sexually abused by her stepfather for years and became pregnant at age 12 and eventually miscarried, appeared in an ad for Besehear's re-election campaign where she said, “To tell a 12-year-old girl she must have the baby of her stepfather who raped her is unthinkable.”

Beshear's Republican opponent, Attorney General Daniel Cameron, responded to that attack by asking Beshear in a debate and afterward how far into a pregnancy a woman should be allowed to get an abortion.

In his campaign and in the interview, Beshear wouldn't say, and turned the tables: "I believe in access, but that's not what we're going to see from this General Assembly," he told Kentucky Health News. "I believe in access with reasonable restrictions. That's not where we are. We are at zero access." 

In the interview and several others this month, the Democratic governor said he thinks he and Republicans who run the legislature can have a more cooperative relationship because he can't seek re-election in 2027.  

"This is the period of time when we can get these things done and not to be seen as a benefit or a detriment, politically," he said. "And I'm already seeing a little difference in tone, and that's everyone. . . . I think we're seeing just a different tone and willingness to talk or to . . . talk differently."

Lt. Gov. Coleman has twin mastectomy, citing exam, family history; says early detection and prevention made the difference

Lt. Gov. Jacqueline Coleman (January 2022 photo)

Kentucky Health News

UPDATE, Dec. 26: Coleman issued a statement saying in part, “My post-surgery reports came back clean! While I am grateful for my amazing health-care heroes, and the relief I feel for having answers, please hear me when I say, if I had put this off, skipped appointments, or not taken it seriously, it is likely the news I’d be sharing eventually wouldn’t be great. Early detection and prevention were the difference makers for me. And they are for you, too. Go schedule that appointment that’s been in the back of your mind.”

Lt. Gov. Jacqueline Coleman underwent a double mastectomy Monday, then issued a statement saying the surgery was prompted by an examination and her family history.

“Concerns were raised to me during a recent routine physical exam,” she said. “With a significant family history of cancer, I made the decision to have a double mastectomy. I am happy to report that a successful surgery was performed today, and I expect to make a full recovery.”

Coleman, 41, was re-elected in November and is considered a likely Democratic candidate to succeed Gov. Andy Beshear in 2027, when he would not be eligible for a third term. He and Coleman said her case was a good example of the need for regular screening exams and other preventive measures.

"Coleman’s office did not immediately clarify if she’d received a cancer diagnosis" or if the surgery was preventive, reports Tessa Duvall of the Lexington Herald-Leader, noting that "Such surgeries can reduce the risk of breast cancer by 90% or more," according to the American Cancer Society. "Certain genetic mutations — such as the BRCA1 or BRCA2 — carry with them a “greatly increased risk of breast cancer,” according to the Susan G. Komen Breast Cancer Foundation."

Coleman said, “As Kentucky’s highest elected teacher, it is only fitting that I leave you with a little homework: Schedule those preventive exams you’ve put off, hug your people a little tighter and be kind, because everyone is fighting a battle you may know nothing about.”

She also said, “I want to thank the health-care heroes for the compassionate care I continue to receive. I am more appreciative than I can articulate for your expertise and your kindness through this process. . . . I am eternally grateful for my loving and supportive family who makes that possible, a compassionate friend in Gov. Beshear and a top-notch staff.”

Abortion-rights lawsuit needs a new plaintiff, ACLU of Ky. says

UPDATE, Dec. 18: The ACLU of Kentucky, lacking a plaintiff, has dismissed its lawsuit.

Abortion-rights advocates are seeking a new plaintiff for their Kentucky class-action lawsuit because the plaintiff, who was eight weeks pregnant, "learned her embryo no longer had cardiac activity," the American Civil Liberties Union of Kentucky and affiliated groups said in a news release Tuesday.

ACLU Reproductive Freedom Project Deputy Director Brigitte Amiri, attorney for the plaintiff identifed only as Jane Doe, said in the release, “We encourage others in Kentucky who are currently pregnant and seeking abortion to reach out to us if they are interested in joining the case—call or text us at (617) 297-7012. We will do everything we can to restore abortion access in Kentucky.”

The lawsuit was filed Friday in state court at Louisville. It alleges that Kentucky's near-total abortion ban of abortion violates privacy and self-determination rights that the state constitution gives the plaintiff and other persons similarly situated, qualifying the case for class-action status.

"Jane Doe sought an abortion in Kentucky, and when she could not get one, she bravely came forward to challenge the state’s abortion ban," Amiri said. "Although she decided to have an abortion, the government denied her the freedom to control her body. Countless Kentuckians face the same harm every day as the result of the abortion ban."

Earlier this year, the Kentucky Supreme Court refused to act against the ban and another outlawing abortion after the sixth week of pregnancy, saying the abortion-clinic plaintiffs didn't have the right to sue on behalf of women, leaving unresolved the constitutional questions about abortion in Kentucky.

The ACLU, Planned Parenthood and other activists said Friday that they had been searching for a plaintiff ever since that February ruling.

The near-total ban was passed in 2019 and took effect when Roe v. Wade was overturned in 2022. It bans abortions except when carried out to save the life of the patient or to prevent disabling injury. It does not include exceptions for cases of rape or incest, which Gov. Andy Beshear used to his advantage in his re-election campaign.

Kentucky voters last year rejected a ballot measure that would have denied any constitutional protections for abortion, but abortion-rights supporters made no inroads in the Republican-controlled legislature's 2023 session in chipping away at the state's anti-abortion laws.

Health Commissioner Stack, master of ceremonies for Beshear's private swearing-in, praises him as he recalls pandemic work

Gov. Andy Beshear took the oath from Court of Appeals Judge
Paula Goodwine as his family held a Bible. (Associated Press photo)

By Al Cross

Kentucky Health News

State Public Health Commissioner Steven Stack was master of ceremonies for Gov. Andy Beshear's private swearing-in ceremony as Tuesday began, providing a platform for him to reflect on his and Beshear's work during the pandemic, work that won public approval and set Beshear up for re-election.

Taking the lectern in the Capitol rotunda after Land Office Director Kandie Adkinson rang bells to start the ceremony, Stack noted that Adkinson had done likewise in the rotunda for each victim of the pandemic. Then he addressed Beshear, recalling their first meeting after his first election in November 2019.

“We could scarcely have anticipated the . . . journey we would soon share," Stack said, alluding to the March 2020 beginning of the pandemic and Beshear's daily news briefings, where Stack usually spoke.

Stack made a point at a briefing as Beshear listened.
(File photo by Matt Stone, Louisville Courier Journal)

“Through thick and thin you supported science” and health professionals, Stack said. Despite criticism of his emergency orders resticting businesses, schools and other activities, polls early in the pandemic showed Beshear with high approval ratings for his work on it, and that was later reflected in his overall job-approval ratings, which remained positive this year despite millions of dollars of attack ads aimed at him.

The private swearing-in is held at midnight because the state Constitution says the governor and lieutenant governor's terms begin on the day five weeks after the election. After Beshear took the oath of office, emphasizing with a smile that “I have NOT fought a duel with deadly weapons,” he said "We will continue our record-breaking economic win streak," reward educators and get "high-speed internet to every home."

He said the state has faced tests from the pandemic, natural disasters and the continuing opioid epidemic, and one of its most difficult challenges is the increased toxicity of politics and governance, with political attacks "turning people against their neighbors just to have one more elected leader with a certain letter after their name." He said he hoped that Kentucky could be "a moral leader for this country."

Stack, returning to the lectern, said people will forget what you say and do, but "People will never forget how you made them feel," and they "don’t care how much you know until they know how much you care." He told Beshear, "The people of Kentucky know how much you care."

After taking her oath, Lt. Gov. Jacqueline Coleman said Beshear "treats every Kentucky family like his own."

In the benediction, the Rev. David Snardon asked, “May we abandon the ideology of separation, seeing ourselves as red or blue, black or white, wealthy or poor.”

Unidentified pregnant woman in Ky. sues for right to get abortion

Abortion-rights supporters chanted April 13 on the second floor of the
state Capitol, where the state Supreme Court meets, one floor below
the legislature. (Associated Press Photo by Bruce Schreiner)

By Bruce Schreiner & Kimberlee Kruesi

Associated Press

A pregnant woman in Kentucky filed a lawsuit Friday demanding the right to an abortion, the second legal challenge in days to sweeping abortion bans that have taken hold in more than a dozen U.S. states since Roe v. Wade was overturned last summer.

The suit, in state court in Louisville, says Kentucky's near-total ban of abortion violates the plaintiff's rights to privacy and self-determination under the state constitution.The plaintiff, identified as Jane Doe, is about eight weeks pregnant and wants to have an abortion in Kentucky but cannot legally do so because of the state's ban, the suit said. She is seeking class-action status to include other Kentuckians who are or will become pregnant and want to have an abortion.

“I am a proud Kentuckian and I love the life my family and I have here, but I’m angry that now that I’m pregnant and do not want to be,” the plaintiff said in a statement released by the American Civil Liberties Union, one of the groups backing her challenge. “The government is interfering in my private matters and blocking me from having an abortion. This is my decision, not the government or any other person’s."

State Attorney General Daniel Cameron's office said it is reviewing the suit but offered no other comments. Cameron, a Republican who lost last month's race for governor to Democratic Gov. Andy Beshear, has defended the state's anti-abortion laws in other court proceedings.

The lawsuit came a day after a judge in Texas gave a pregnant woman whose fetus has a fatal diagnosis permission to get an abortion. The restraining order issued Thursday stopped Texas from enforcing the state’s ban on the mother of two, who is 20 weeks pregnant. Late Friday, the court stayed the ruling, pending closer consideraiton of the case. UPDATE, Dec. 11: The woman, citing the delay, said she was leaving Texas to get an abortion in another state.

Unlike the Texas case, little is known about the Kentucky plaintiff or her pregnancy. Legal challenges across the nation have largely highlighted stories from women who were denied abortions while facing harrowing pregnancy complications. But in Kentucky, the plaintiff's attorneys insisted they would fiercely protect their client's privacy, stressing that Jane Doe believes “everyone should have the right to make decisions privately and make decisions for their own families,” said Amber Duke, the ACLU of Kentucky's executive director.

Earlier this year, the Kentucky Supreme Court refused to halt the state's near-total abortion ban and another outlawing abortion after the sixth week of pregnancy. The justices focused on a narrow legal issue, saying an abortion clinic didn't have the right to sue on behalf of women, but didn’t resolve larger constitutional questions about whether access to abortion should be legal in the Bluegrass State.

The ACLU, Planned Parenthood and other activists say they've been searching for a plaintiff ever since that February ruling. The suit filed Friday marks the launch of their new assault against the state's abortion bans.

“These bans have harmed countless Kentuckians since going into effect last year, and we are relieved to be back in court to try to restore abortion access in Kentucky,” Brigitte Amiri, deputy director of the ACLU Reproductive Freedom Project, said in the news release.

The lawsuit says Kentucky women are suffering “medical, constitutional and irreparable harm” by being denied the right to obtain abortions.

“Abortion is a critical component of reproductive healthcare and crucial to the ability of Kentuckians to control their lives,” the suit says. “Whether to take on the health risks and responsibilities of pregnancy and parenting is a personal and consequential decision that must be left to the individual to determine for herself without governmental interference.”

Kentucky voters last year rejected a ballot measure that would have denied any constitutional protections for abortion, but abortion-rights supporters have made no inroads in the Republican-controlled legislature in chipping away at the state's anti-abortion laws.

The legal challenge revolves around Kentucky’s near-total trigger law ban and a separate six-week ban — both passed by Republican lawmakers. The trigger law was passed in 2019 and took effect when Roe v. Wade was overturned in 2022. It bans abortions except when carried out to save the life of the patient or to prevent disabling injury. It does not include exceptions for cases of rape or incest, which Beshear used to his advantage in the race with Cameron.