Kentucky can't afford health exchange or Medicaid expansion, senator says

12/26/2012 04:31 PM

Improving the health of Kentuckians, who as a group are among the sickest in the country, should be a priority for state leaders, one key senator said, but not at the risk of the state’s financial health, which is equally ailing.

“I think it’s critical that we take a look at those to see how we achieve that. I’m not sure that this would be the way that would be best-suited to Kentucky and be fiscally responsible for the state of Kentucky,” said Sen. Julie Denton, R-Louisville and chairman of the Senate Health and Welfare Committee, at 4:10 of the interview.

The biggest developments in public health care expected in 2013 are the creation of a health insurance exchange network and the decision to expand Medicaid — both offshoots of the Affordable Care Act.

Kentucky is one of 19 states moving forward with setting up a health benefits exchange. The exchanges will match up uninsured Kentuckians with private health insurance. Gov. Steve Beshear’s administration has used federal grants to cover the set-up costs and estimates the exchange will cost $39.5 million a year to run.

But Denton said she’s skeptical about those numbers. And she said she would prefer the federal government to set it up.

“If they think this is such a wonderful plan, let them implement it. And I think it’s much better if you can implement it on a wide scale,” she said at 0:50. The legislature could decide to overrule the governor’s decision when the General Assembly convenes in January, she added.

There’s another reason she said she’d rather see the federal government try to set it up. (Watch at 1:40)

The Affordable Care Act calls for expanding Medicaid to cover those making up to 138 percent of the poverty rate — about $32,000 a year for a family of four. Under that provision, Kentucky could add 300,000 more people to its rolls, bringing the total to more than 1.1 million. That would mean about a quarter of Kentuckians would have their health covered by the Medicaid program.

The federal government would cover the entire tab of the expansion from 2014 until 2017 when the state would have to pick up 5 percent of the costs. From there, the state’s share would increase to 10 percent by 2020.

“Frankly, I don’t think we can afford to do it,” Denton said.


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