His health initiatives in the political crosshairs, Gov. Beshear defends kynect, Medicaid expansion

11/14/2015 09:53 AM

Gov. Steve Beshear gave a forceful defense of federal health programs he enacted during his final term in office, urging Gov.-elect Matt Bevin, who campaigned aggressively on scrapping the state-based exchange kynect and altering expanded Medicaid, to reconsider his position on Friday.

Beshear mentioned Bevin by name repeatedly during a Capitol news conference highlighting recent health progress in the state, pointing to statistics showing increased health coverage and economic activities in his appeal to the Republican.

“During election season the political rhetoric tends to be strong and the promises bold,” said Beshear, a Democrat. “But the fun and games are over, and it is time to get serious.”

Scrapping kynect, he said, would make Kentucky the first state to shutdown a functioning health exchange and cost the state $23 million in transitioning to the federal exchange, which charges insurance providers 3.5 percent on premiums compared to kynect’s 1 percent assessment.

Despite Beshear’s pleas, however, Bevin’s transition team gave no indication that the incoming governor planned to back away from his campaign pledges to shutter kynect and seek waivers from the Centers for Medicare and Medicaid Services in adopting a new Medicaid expansion model. Both were optional provisions of the Affordable Care Act, and Bevin has often referenced Indiana’s expanded Medicaid system, which requires monthly premiums between $1 and $27.

“Governor-Elect Bevin has laid out a health care vision for Kentucky that will encourage personal responsibility and focus on expanding access to quality, affordable health care coverage,” Jessica Ditto, spokeswoman for Bevin’s transition team, said in a statement.

“His administration will move forward in addressing Kentucky’s health care needs in a deliberate and thoughtful fashion, consulting with Kentucky’s health care stakeholders, his Cabinet appointees and the General Assembly.”

Asked about Bevin’s plan to seek CMS waivers and potentially charge premiums on Medicaid recipients eligible through expansion, Beshear said he doesn’t believe waivers will have much impact on the program’s cost and premiums have “pros and cons.”

Beshear said Bevin should look to GOP-led states that have expanded Medicaid eligibility like Ohio, Nevada and Michigan, the latter of which received CMS waivers and charges premiums on those with incomes above 100 percent of the federal poverty level.

“You can certainly debate whether those that can afford it should have to put a little something in and that gives them more respect and makes them feel better and they take more ownership in it,” he said.

“You can also look at it as, you know, people are usually well most of the time, and if I’m only making $30,000 a year and I’m supporting a family of four and everybody’s well right now and I can take $30 a month or $50 a month that I would have to pay in in order to be covered here and use it to feed my family or buy the textbooks that our kids need to go to school, people are tempted to say, ‘Well, I really don’t need this health care right now. I need this money to support my family.’”

Beshear said Bevin should look to the economic and social benefits of expanded Medicaid, saying enrolling more low-income Kentuckians “is helping us chisel away at health problems that have plagued us for generations.”

More than 400,000 have enrolled in expanded Medicaid, dramatically shrinking the state’s uninsured rate while putting about 1 in 4 Kentuckians on the health program for the poor.

Beshear said the next biennial budget will benefit from an estimated $300.2 million because of expanded Medicaid eligibility, which he enacted through executive order. One of Bevin’s first, and most important, tasks as governor will be to craft a two-year spending plan for the General Assembly to consider in next year’s legislation session that begins in January.

The state’s $257.3 million match for expanded Medicaid in fiscal years 2017 and 2018 would be offset by $557.5 million in estimated new revenue, $246.8 million of which is expected to come from newly created sales and income taxes because of the expansion, Beshear said.

“Of course, if we get rid of expansion and those health care customers go away, it all happens in reverse,” he said.

Ditto, in her statement, said Beshear’s most pressing challenge will be to “re-enroll the 51,000 Kentuckians who are losing coverage due to the collapse of the Kentucky Health Cooperative.”

“Those Kentuckians know first-hand the failures of Obamacare,” she said. “The urgent task of re-enrolling Kentuckians who lost coverage remains firmly in Governor Beshear’s court.”

Beshear reiterated his stance that the non-profit’s demise will have little impact on those seeking health insurance through kynect “because we have seven private companies offering insurance” during this year’s open enrollment period, two more than last year.

Beshear’s public appeal to Bevin follows a closed-door meeting the two had after the Republican won last week’s gubernatorial election over Attorney General Jack Conway, besting the Democrat by 9 percent in the contest.

Beshear said the two agreed not to disclose details of the conversation, but he said he talked about the health initiatives that will be reconsidered by the next governor.

“I am encouraging this incoming administration to look at the data,” Beshear said. “Just look at the facts. Look at where we are today as opposed to where we are two or three years ago and make decisions based on those facts and those figures, and most of all make decisions based upon what’s best for the people of this state.”

While their political philosophies and views on health care may differ, both the departing and newly elected governor agree on one point: “The time for politics is over,” Ditto said.


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