Battle to halt rollback of kynect, Medicaid expansion is about the people, former Gov. Beshear says
03/09/2016 05:52 PM
After two terms in office, former Democratic Gov. Steve Beshear has a fight on his hands to convince first-year Republican Gov. Matt Bevin to halt a rollback of the state’s health insurance exchange and transition expanded Medicaid recipients to the federal government.
If Bevin is successful in transitioning services, Kentucky would be the first state in the nation to shut down a working state exchange.
Beshear has created a non-profit group, Save Kentucky Healthcare, to oppose changes to the healthcare system he put in place during his tenure.
Kentucky’s exchange was heralded as a national success under the Affordable Care Act, but Beshear warns this isn’t about two people, but rather about the health of the state.
“This is not about Gov. Bevin and me,” Beshear said in an interview with Pure Politics. “I know that politically people like to posture it like that. This is about healthcare for Kentuckians. I hope at the end of the day Gov. Bevin and I agree that every single Kentuckian deserves to have affordable healthcare.”
“I don’t know whether he believes it or not,” Beshear continued. “I hope he does. Because a leader in Kentucky, a governor in Kentucky, I think needs to believe in the health of his people and providing healthcare for the people.”
Under Beshear, Kentucky expanded Medicaid, a social health care program to help low-income earners, to those earning up to 138 percent of the federal poverty level. Beshear also implemented an integrated state-based exchange known as kynect, where uninsured Kentuckians could be matched with Medicaid if they met the federal guidelines or qualified health plans.
The federal government under President Barack Obama paid for Kentucky to set up and pay for the exchange under Beshear.
“It works,” Beshear said of kynect. “It’s been the model in the nation. … Where is the argument other than it’s something set up by President Obama and I don’t like it?”
What Beshear said Kentuckians should be watching is what Bevin does with the expanded Medicaid population.
Bevin has shown the capacity to move on the issue of healthcare from where he was during the election season. The state-based exchange he once promised to do away with is essentially replicated by using the website Benefind to only apply for Medicaid, Kentucky Children’s Health Insurance Program, the Supplemental Nutrition Assistance Program and the Kentucky Transitional Assistance Program.
“They’re now talking about some type of hybrid type of thing,” Beshear said of Benefind. “And they’re talking about maybe some waivers in the Medicaid program.”
Dollars and sense
Bevin has fought the exchange, calling the program unsustainable, but Beshear argues that the program is already creating jobs and revenue for the state.
The current administration claims that the by transitioning to the federal exchange, Kentucky will save $20 million a year, and Bevin says it will cost far less than previously expected to shut down the kynect website in IT costs.
Regardless of the name, Beshear said one way or another the state would have a healthcare exchange. And whatever the costs are for the programs, it will still cost the state more in the expanded Medicaid population, Beshear said.
Bevin’s moves won’t save any dollars in the long run by switching services, unless he reduces the population, he said.
Beshear referenced reports from Deloitte Consulting and a report from the Bevin administration which shows job growth from the medical field after the Medicaid expansion.
The Kentucky Center for Economic Policy released a graph showing the increase in medical-related fields, based on a report from the Kentucky Labor Market Information and the Bureau of Labor and Statistics.
“What it means is that it’s growing the economy,” Beshear said. “Those people are paying taxes that money is available to cover any excess cost of this program and it will pay for itself in the long run.”
Some of the studies Beshear cites which predicted Medicaid expansion would create jobs and come at a $30 billion boon to the state’s economy, but Senate President Robert Stivers, R-Manchester, said the studies missed the mark when they predicted that expanded Medicaid eligibility would add just 200,000 people to the program.
“Price Waterhouse Coopers had projected that 200-something thousand people would get on the rolls because of that and we actually had 400,000. Great. Because there were that many people that needed healthcare,” Beshear said in response.
Bevin has called the studies “baloney,” but Beshear said Bevin is still using the consulting group — Deloitte.
“Anybody that’s against this just because it had President Obama’s name on it, they’re not going to be paying attention to numbers, they’re not going to pay any attention to facts, but all I ask them is give us some facts, give us some evidence, give us some studies,” Beshear said.
Beshear predicted that the people who are in the Medicaid program now will become healthier, seek better employment and move out of the Medicaid system and into the qualified health plans.
The former governor went on to say the only argument he hears is the economic cost of the program being unsustainable, his counter came in the form of a challenge.
“That’s just not true, or if it is true, prove it,” he said.
Shutting it down
The cost of shuttering the state portal to affordable health insurance is also a point of contention between the two governors. Initially, Beshear said that Deloitte Consulting told his administration during the summer of 2015 that it would cost $23 million to shut down the program, when the issue was raised on the campaign trail.
Deloitte later shuttered a state-based exchange in another state that wasn’t operating correctly. After the shutdown, Beshear said the group had created a program that was less expensive, but he said the group never shared the number to end Kentucky’s exchange and transition.
Still, he thinks the Bevin’s administration’s predictions that the transition would cost less than $240,000 are “ridiculous.”
“I would like to ask the Bevin administration to ask Deloitte to come out and talk about it. You know, I think that would be good for everybody,” Beshear said.
At the end of the day, Beshear said there shouldn’t be an argument over numbers, the argument he suggested should be about whatever system the state has if it’s good for Kentuckians.
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