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Study: Medicaid Expansion Led To Dramatic Drop In Kentucky Uninsured

A new study says the number of low-income Kentuckians without health insurance declined by 68 percent in the first year of the state's Medicaid expansion.

The research was conducted by the University of Louisville's School of Public Health and Information Sciences Department of Health Management and Systems Sciences by faculty members Joseph Benitez, Liza Creel and J’Aime Jennings.

It was published Wednesday in Health Affairs.

The study said 35 percent of low-income Kentuckians were uninsured at the end of 2013, and 11 percent were uninsured in late 2014. The research aligns with past studies that show sharp drops in the rate of uninsured in Kentucky since the Affordable Care Act was implemented.

Benitez and his colleagues also found declines in the number of people lacking a regular source of health care and those with unmet medical needs.

"We do find large up upticks in coverage among people under $25,000 of annual income as well as large improvements in having an unmet medical need because of cost," Benitez said.

Researchers focused on adults between 25 and 64-years-old who earned an annual household income up to $25,000, using data from the Centers for Disease Control and Prevention.

The Medicaid Expansion Report, compiled by Deloitte Consulting and commissioned by then-Gov. Steve Beshear, said a total of 310,887 people enrolled in Medicaid in 2014.

The implementation of the Affordable Care Act was done under former Beshear, a Democrat, by executive order. Under the ACA, Beshear expanded Medicaid to residents who earned 138 percent of the federal poverty limit.

Current Gov. Matt Bevin, a Republican, is moving forward with plans to dismantle Kynect, the state's health care exchange, and reform the state's Medicaid system. Recently, Bevin announced the creation of Benefind, a website that will replace Kynect as the way for Medicaid beneficiaries and other welfare recipients to apply for services starting Feb. 29.

But Benitez said those transitions could reverse the progress the state has made in lowering its uninsured rate. Before the ACA, Kentucky's uninsured rate was 20.4 percent. Now, it's 7.5 percent.

"It does seem like a large segment of people, not just among the low-income group but even some incomes … above $25,000 or even higher incomes are engaged in using Kynect … as a way to identify coverage," he said.

Beshear recently launched the non-profit Board for Save Kentucky Healthcare. In a statement, he said "this recent analysis highlights a long and successful track record of providing sustainable healthcare coverage to Kentucky residents most in need.”

The state's new Medicaid commissioner recently told legislators that the expansion will cost the state about 20 percent more over the next two years, to $3.7 billion. Bevin has said the Medicaid expansion and Kynect are too costly for the state.

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