Gov. Matt Bevin said Monday despite praise for Kentucky’s embrace of the Affordable Care Act in recent years, the initiative has been an “abject failure” in the state.
“Kentucky, which has long been vaunted as an example of the opposite, I’m telling you as a matter of fact has been an unmitigated disaster,” Bevin said at a news conference after governors attended an event with President Trump.
Bevin has long opposed the Affordable Care Act, which made more people eligible for Medicaid in Kentucky and created a state exchange, Kynect, for people to purchase health insurance.
The governor has scrapped Kynect and applied for a federal waiver to change the state’s Medicaid expansion by eliminating some benefits and requiring most recipients to pay premiums costing between $1 and $15 per month.
Under the GOP plan to replace the Affordable Care Act — per a Politico story from Friday —states like Kentucky that expanded their Medicaid systems would lose federal funding for the programs starting in 2020.
Bevin said that federal funding has been wasted on a “broken” Medicaid system.
“The reality is that it’s the people’s money, it’s taxpayers' money and whether we’re wasting it at the federal level or the state level or somewhere in between, it’s inappropriate to waste the taxpayer’s money,” he said. “I’m not even a little bit concerned over Kentucky getting less federal money to waste. If we don’t have a good place to deploy it we shouldn’t get the money.”
Until this fiscal year, the federal government subsidized 100 percent of Kentucky’s Medicaid expansion. That subsidy drops to 95 percent during this fiscal year and to 90 percent in the 2020 fiscal year and beyond — leaving the state with an estimated $294 million Medicaid tab.
Former Gov. Steve Beshear authorized the expansion of Medicaid and created the health exchange by executive order. The expansion added about 400,000 people to the state’s Medicaid roles and more than 80,000 people got health insurance through Kynect.
But Bevin said though people have health insurance, the Affordable Care Act isn’t making people healthier.
“Simply providing coverage — and that’s something I would challenge you all to realize — it’s not purely about coverage, it’s about access to and the receipt of health care so that folks have better health outcomes,” Bevin said.
Since 2013, Kentucky's uninsured rate has gone from more than 20 percent to less than 8 percent.
Ben Chandler, CEO of Foundation For A Healthy Kentucky, said that more people with insurance in the state is a good thing.
"We’ve got far, far fewer uninsured people than we used to have," Chandler said. "And people are accessing their doctors more often. We’ve seen an uptick in doctor visits and screenings. People are getting more preventive care. I don’t see how those things are anything but pluses."
According to a Foundation For A Healthy Kentucky report, Medicaid covered about 44,000 dental screenings, 10,000 breast cancer screenings and 7,000 births for Kentucky adults between July and September 2016.
More than 78 percent of those screenings were for those who became eligible for Medicaid after the program was expanded, according to the report.
As Congress considers a replacement plan for the Affordable Care Act, former Gov. Beshear has been selected to speak in response to Trump’s address to Congress on Tuesday evening.
Bevin, who has bitterly feuded with Beshear since being elected in 2015, called his selection an “interesting choice,” and criticized the former governor for what he called a “remarkable decline in access to coverage.”