Ky. GOP lawmakers predict state can't afford Medicaid expansion, Democrats say Ky. can't afford not to

10/21/2013 05:54 PM

As the first batch of uninsured Kentuckians slowly sign up for health insurance, state lawmakers remain just as divided over whether the approach taken by the Affordable Care Act will, indeed, be affordable for Kentucky.

As of last week, Kentucky’s health exchange — a marketplace set up to match uninsured with private health coverage or Medicaid, if their income is low enough to qualify — had received more than 25,000 finished applications. Of those, 18,406 were enrolled in health coverage, according to Carrie Banahan, director of the Kentucky Health Benefits Exchange. Two-thirds of those now enrolled are eligible for Medicaid now that Gov. Steve Beshear issued an executive order to expand the income eligibility up to those making 138 percent of the federal poverty rate. That’s about $33,000 for a family of four.

But Kentucky has 640,000 uninsured people, including an estimated 308,000 who would qualify for newly-expanded Medicaid.

Two Republican state lawmakers and two Democratic ones at a health forum last week at Owensboro Medical Health System outlined the philosophical divide that remains about whether the approach taken by the Affordable Care Act nationally — and the expansion of Medicaid as part of that in the state — will provide a net benefit or a loss to Kentucky.

“We need to make sure that folks have access to care. We need a safety net,” said Rep. Ben Waide, R-Madisonville, who is a physical therapist. But he said Medicaid already is shorting providers. So, he said, it won’t do much good if those enrolled in Medicaid can’t find any doctors to treat them.

Democratic House Whip Tommy Thompson of Philpot referred to some of the numbers cited by Banahan and said that with tens of thousands of people seeking coverage in the first three weeks of the exchange being open is a key signal that Kentuckians are “thirsty” for health coverage.

But, as it often does, it comes down to money.

The federal government will cover the expansion of Medicaid for the first three years. Then starting in 2017, Kentucky will have to kick in 5 percent of the costs. That will go up to 10 percent by 2020.

So where does that money come from?


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