GOP Senate leader outlines constitutional and logistical concerns with Beshear's expansion of Medicaid

05/24/2013 10:40 AM

One of the Republicans who has worked closest with Democratic Gov. Steve Beshear in the past said the governor was wrong to expand Medicaid because the system already is “broken.”

Senate Republican Floor Leader Damon Thayer said Medicaid already is struggling to cover disabled Kentuckians and those earning below the poverty line. Specifically, the managed care companies hired by the state to hold down Medicaid costs have angered doctors and hospitals, who say the firms aren’t always paying them for treating Medicaid patients. (2:45 of the interview.)

“We already know that Medicaid is broken. Doctors are not accepting Medicaid patients across Kentucky. We already know that Medicaid does not already do a good job right now delivering needed services to those making below the poverty line. And now we’re going to expand it and tie it into a federal bureaucracy?” Thayer said.

And he responded to proponents of expansion, such as Rep. Darryl Owens, D-Louisville, who said on Pure Politics that Kentucky couldn’t afford not to expand Medicaid because it would increase access to health care for more low-income Kentuckians to provide more preventative care. (4:00)

And Thayer said the governor shouldn’t have been able to do so without the General Assembly’s blessing. Thayer, the Georgetown Republican who worked with Beshear on casino gambling and pension bills, blamed the Democratic-controlled House for not taking up a bill during the 2013 session that would have required legislative approval for Medicaid expansion and the set-up of health benefit exchanges.

“That abdicated the legislative independence that many of us have worked hard to achieve and left the governor with the ability to go ahead, with the stroke of his pen, and implement Obamacare in Kentucky,” Thayer said (1:00).

Thayer declined to comment on the lawsuits brought by tea party activist David Adams. Adams has challenged Beshear’s ability to expand Medicaid and set up Health Benefits Exchanges as part of the Affordable Care Act without legislative approval. Beshear has said the health exchange will be paid for, in part, by “assessments” or fees on insurance companies, which Adams — and Thayer — questioned as a tax by executive branch fiat.

“I think there is a legitimate issue here about the separation of powers,” Thayer said.


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