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.”

Poll shows plurality in Kentucky still favors Obamacare; Chandler says numbers suggest opinion of law has settled in state

Kentuckians remain divided about the Patient Protection and Affordable Care Act, but for the second straight year more of them clearly favor it than oppose it, according to the latest Kentucky Health Issues Poll co-sponsored by the Foundation for a Healthy Kentucky.

Taken Aug. 26 through Oct. 21, the poll found that 44 percent of Kentucky adults have a "generally favorable" opinion of the 2010 law, while 33 percent are "generally unfavorable" and the rest said they didn't know.

“I feel like this suggests that the number has settled into a place where it will not move,” Ben Chandler, president and CEO of the foundation and a former congressman and state attorney general, told the Louisville Courier Journal.

The numbers were the same as the poll taken in fall 2017, less than a year after its unofficial namesake and chief proponent, Barack Obama, ended his term as president. Since 2014, when "Obamacare" was fully implemented, Kentuckians' opinion of it had been marginally unfavorable.

Only 56 percent of those polled said they knew enough about the law to understand how it would affect them personally, and 53 percent said it has had no effect on them or their families; 21 percent reported negative impacts and 18 percent reported positive impacts. The poll's margin of error is plus or minus 2.5 percentage points for each number.

The law remains politically controversial, and that was reflected in its reported impact in the poll. Among Democrats, 31 percent said it had positively affected them and their families, while only 11 percent of Republicans said that while 29 percent of them said it has had a negative affect. Only 9 percent of Democrats reported a negative affect.

Ben Chandler

Chandler told CJ political writer Phillip Bailey that Kentuckians have been affected mainly by the expansion of the Medicaid program to almost 500,000 people and changes in the market for individual health insurance, which affected fewer than 300,000. About 90,000 Kentuckians have health insurance policies that are subsidized by the law; the state has almost 4.5 million people.

Chandler, a Democrat, voted against the law as Sixth Congressional District representative. He told Bailey that it has suffered from "misinformation" for years, he doesn’t regret his vote. "I never thought it was a political winner, personally," he said. "I think health care is too difficult to explain, and it's too easy to frighten people with."

Bailey writes, "Chandler, who was booted out of office in 2012, said the law hasn't covered as many people as he would have liked and hasn't cut costs to the extent he would have liked either. He described the health care law as 'essentially the Republican free-market approach to coverage' that didn't do enough. The former congressman said that the law has also been too steep of a price for Democrats at the ballot box."

Chandler said, "When it passed in 2010, the cost was so dramatic it has essentially cost, in my opinion, Democrats control of governments both on the state and national level ever since. How many other laws could have been passed that would have been beneficial from a Democratic point of view that weren't able to be done because of the controversy surrounding the Affordable Care Act?"

The poll asked these questions about the law:

“As you may know, a health-reform bill called the Affordable Care Act was signed into law in 2010.  Do you feel you have enough information about the health-reform law to understand how it will impact you personally, or not?”

“Overall, which of the following statements would you say best describes the impact of the health reform law on you and your family personally: The health-reform law has positively affected me and my family; the health-reform law has negatively affected me and my family; or the health-reform law has not had an impact on me and my family.”

For more details, click here.

Lexington, Paducah newspapers' editorials take diametrically opposing sides on Bevin's proposed changes to Medicaid

Governor Matt Bevin (Photo from politicususa.com)

By Danielle Ray
Kentucky Health News

Kentucky's most reliably liberal editorial voice and one of its most reliably conservative are, not surprisingly, on opposite sides of Gov. Matt Bevin's plan to change the Medicaid program.

Bevin has proposed changes that would transition 86,000 Medicaid recipients to private insurance within five years, according to estimates from his administration. His proposal would require "able-bodied" recipients to pay a monthly premium of between $1 to $15, depending on income. If a person wanted dental or vision insurance, he or she would have to do such things as enroll in a community-college course, get a job or enroll in a smoking-cessation program.

The Lexington Herald-Leader published an editorial Sunday that calls Bevin's proposed changes a "red-tape tangle of penalties, incentives, premiums and cutbacks in coverage." The newspaper argues that the plan would create new administrative costs while caring for fewer Kentuckians.

The Herald-Leader does not reject the governor's plan wholesale. It applauds certain aspects, such as creating rewards for quitting smoking. It also backs Bevin's pilot program that would expand access to residential treatment for addiction and mental illness in 20 counties in an effort to quell the state's drug abuse epidemic and prevent the spread of hepatitis and HIV.

And the paper likes Bevin's renegotiation of contracts with Medcaid managed-care companies, which administration officials say will save taxpayers $280 million over the next six months. The state's five managed-care firms earned far higher profits than their counterparts in every other state in 2015, the research group Milliman reports.

Jim Paxton, publisher of The Paducah Sun, welcomes the governor's proposed changes. His editorial, which is behind a membership paywall, in Sunday's Sun says change is needed because then-Gov. Steve Beshear added more than 400,000 Kentuckians to the program, something that Bevin, Paxton and many other conservatives see as unsustainable. Paxton says one of every four Kentuckians now qualifies for Medicaid, which he implicitly deems unacceptable.

The federal government is picking up the full tab for the expansion under through this year, under federal health reform. Next year, the state will begin paying 5 percent of the cost, rising in annual steps to the law's limit of 10 percent (expected to be more than $360 million) in 2020. Paxton says Bevin was elected to clean up Beshear's mess and calls his plan "a creative, fair and rational step to do so."

The public may send comments on Bevin's plan to Medicaid Commissioner Stephen Miller or email kyhealth@ky.gov by July 22. A public hearing was held Tuesday in Bowling Green. Hearings will also be held Wednesday in Frankfort and July 6 in Hazard.

Almost as many Kentuckians support health reform as oppose it, but half say they don't know how it may affect them

By Al Cross and Melissa Patrick
Kentucky Health News

The federal health-reform law is gaining support from Kentuckians, to the point that they are almost evenly divided about it.

Those are among the results of the latest Kentucky Health Issues Poll, conducted for the Foundation for a Healthy Kentucky among a random sample of almost 1,600 Kentucky adults Oct. 8 through Nov. 6, the final month of an election season in which the law was an issue.

After two years in which opinion of the law was clearly unfavorable, the poll found that 39 percent view it favorably while 41 percent view it unfavorably. That is well within the poll's error margin of plus or minus 2.5 percentage points, which applies to both numbers.

The findings are similar to a national survey taken at about the same time. The October 2014 Kaiser Health Tracking Poll found that 36 percent of U.S. adults had favorable views of the law; 43 percent were unfavorable, and 20 percent did not know or offered no opinion.

In the Kentucky poll, about as many people reported a negative impact from the law (21 percent) as a positive impact (18 percent). The positive-impact number rose form 7 percent in the 2013 poll, which was taken just after enrollment for expanded Medicaid and subsidized health insurance had opened.

Notably, 51 percent of those polled said they didn't have enough information to know how the law would affect them personally. That was down from 57 percent a year earlier.

Most of those who reported not having enough information, 64 percent, had not graduated from high school. Almost half of Kentuckians (47 percent) said they understood how the law would impact them personally. Sixty-six percent said the law had no effect on them.

“KHIP data trends show overall support for the ACA has risen since 2013 as more Kentuckians have gotten information about the law," Susan Zepeda, President and CEO of the Foundation for a Healthy Kentucky, said in a press release. "More work is needed to educate people about the law’s provisions and potential impacts on families.”

The poll was also conducted for Interact for Health, formerly the Health Foundation of Greater Cincinnati, by the Institute for Policy Research at the University of Cincinnati. It used landline and cell phones.

Opinions of the Patient Protection and Affordable Care Act, often called Obamacare, are still driven partly by politics. The survey found that 58 percent of Democrats had favorable views of the law and 64 of Republicans had unfavorable views. Among independents, 42 percent had unfavorable views and 31 percent were favorable.

Weekly paper in Carter County runs voluntary-response survey about statewide smoking ban, finds slim majority in favor

Wikipedia map: Carter County

The Journal-Times, the weekly newspaper in Carter County, is running an online "poll" of reader opinions about the proposed statewide smoking ban and finding a slim majority in favor of it. At 4:20 p.m. Sunday, 52.3 percent of the voluntary respondents said they favored the legislation, while 45.4 percent said they opposed it and 2.3 percent said they didn't care.

Despite those numbers, reporter Leeann Akers writes that the idea "seems to be unpopular in Carter County," based on "overwhelming opinion on social media." She cites the Facebook page of the Carter County Citizens For a Better Way and this post from Brandon Boggs: “If a business wants to prohibit smoking they have that right, however, we have the right to support that business or not depending on our personal preferences.”

Some posters on the page favor the ban. Travis Horton wrote: "I as a nonsmoker think people that smoke in restaurants or in businesses are showing disrespect for people with health issues and other things."

A continuing national survey by the federal Centers for Disease Control has found that between 31 and 46 percent of Carter County residents smoke, with the most likely number being 38 percent, well above the statewide figure of 29 percent in the same survey.

Akers reports that the county's two state legislators, "Sen. Robin Webb and Rep. Jill York, both say they remain undecided on how they will vote if it comes to the floor but both have a history of following their voters." She gives the legislators' email addresses and the telephone number to leave a message for them.

"This is the sort of story that most local newspapers with websites can do," said Al Cross, director of the Institute for Rural Journalism and Community Issues, publisher of Kentucky Health News. "But I suggest that they avoid calling any voluntary-response survey a poll, because that word implies that the results are from a scientific, random sample, and that they remind readers of that in giving the results."