By Al CrossKentucky Health News
Opponents of federal health reform kept up their drumbeat Tuesday as Gov. Steve Beshear announced the latest, but still not quite final, signup figures from
Kynect, the state health-insurance exchange.
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Kynect Executive Director Carrie Banahan listened to Beshear.
(Lexington Herald-Leader photo by Pablo Alcala) |
Beshear held a news conference to announce that 413,410 Kentuckians enrolled for coverage via the exchange through April 11, when most enrollment in private insurance plans closed until Nov. 15. he said "A significant number" of paper enrollments are still being processed. Enrollment is open year-round for the Medicaid program and for people who experience a major event such as change of jobs or birth of a child.
So far, 68 percent of those who signed up for a private insurance policy through the exchange have paid their premiums, according to a state press release. About three-fourths of the policies are from the
Kentucky Health Cooperative, a non-profit insurance company created under the Patient Protection and Affordable Care Act, known as Obamacare. The rest of the market was about equally divided between
Humana Inc. and
Anthem, the only for-profit company offering exchange policies statewide.
Beshear said state officials estimate that three-fourths of exchange enrollees did not have health insurance when they signed up, and Health and Family Services Secretary Audrey T. Haynes estimated that the number of uninsured Kentuckians has dropped to around 200,000, from an estimated 640,000. She said an unknown number of the uninsured obtained insurance outside the exchange.
About three-fourths of the exchange enrollees are in Medicaid, which Beshear expanded to cover people with household incomes up to 138 percent of the federal poverty threshold. The previous income limit was only 69 percent of poverty. The federal government will pay the entire cost of covering the newly eligible people through 2016, when the state will have to start picking up a small share, reaching a cap of 10 percent in 2020.
The federal government pays about 71 percent of benefits for previously eligible Medicaid recipients in Kentucky. Some who had been eligible but never enrolled signed up through the exchange; Haynes said she didn't know the number, but said she still feels good about the estimate of 17,000, made before the exchange opened Oct. 1.
Beshear reiterated his belief, based on a study by the international accounting firm
PriceWaterhouseCoopers, that expansion of Medicaid will pay for itself by expanding the health-care industry and creating 17,000 jobs. Republicans in the General Assembly have expressed skepticism about that but have offered no countervailing information.
The leading Republican attacker has been U.S. Sen. Mitch McConnell, who sent Kentucky newspapers his latest
column on the subject Monday, saying claims that the law has been successful are refuted by the experiences of those who had their policies canceled despite President Obama's promise that they could keep them, and have had to pay higher premiums and deductibles, "often for a plan that offers less access to hospitals and their favorite doctor."
McConnell called "shocking" the signup of inmates by jails and prisons, which he said could limit access to care because the demand for it may outstrip the supply of doctors, nurse practitioners and other health-care providers. Officials have said the signups save the state money by transferring costs to the federal government.
Asked about McConnell's criticism, Beshear said, "These critics continue, apparently, to sit in their own echo chambers and talk to each other, because when you get out and talk to these 413,000 people, they are very thankful that we have moved forward both in expanding the Medicaid program and in setting up our own health-benefits exchange." Haynes said the program has been "overwhelmingly successful by all measures."
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Tea party activist David Adams, who is appealing initial adverse rulings in two lawsuits he filed to challenge Beshear's actions, disputed the estimate that three-fourths of the exchange enrollees had been uninsured, "arguing that enrollment questions on the Kynect website prompted people to falsely claim that they lacked insurance when submitting applications," Mike Wynn
reports for
The Courier-Journal.
Beshear said the reform law is "a tool to improve people's health, to help those who are vulnerable to to remove lack of health coverage as the determining actor in a family's financial security." He said the nearly-final enrollment figure is "a milestone that shows just how important health-care reform is to our families and our future. . . . We're going to keep enrolling people until everybody in Kentucky who needs health coverage has health coverage."
Skeptics of the law say research has shown that enrollment in Medicaid doesn't improve enrollees' health, but defenders say that study didn't last long enough. Beshear said, "It'll probably take several years to see a change in our rankings, but you will see a change in our rankings over the next generation." He said the reform law's emphasis on prevention and wellness will give the state a healthier workforce that will attract more jobs.
Republicans are making Obamacare the centerpiece of their campaigns for the Nov. 6 elections, but Beshear told
The Washington Post in January that by Election Day the law will be a net plus for Democrats. Asked yesterday if he would recommend to Democrats in the legislature that they use the reform law in their campaigns, he said candidates will have to make their own decisions, but "The Affordable Care Act, some next November, is going to be looked at a lot differently than it was looked at last November," when the national rollout was very troubled.
"The 80 percent of Americans and Kentuckians whom the Affordable Care Act will not affect at all are gonna know that it's not gonna affect them, so it's not gonna be a big issue for them one way or the other," Beshear said, and the 20 percent who are affected "like what they're getting. . . . I would say to those who think they're gonna make this the crowning issue and defeat somebody on it, have at it, because I don't think they're gonna get to first base by next November."
Reminded that Republicans use the law's nickname to run against a president who is unpopular in Kentucky, and asked when the tipping point in public opinion might come, Beshear suggested that he will find a way to gain political advantage.
"Whether you see a big change in the polling numbers when you use the phrase Obamacare or not, I don't think is gonna be all that relevant come next November, because people out here in Kentucky are gonna hear a lot about Kynect and the Affordable Care Act and the successes that we've had," he said. "I think you are seeing the polling now, when you talk about Kynect and what is going on in Kentucky, that people are very favorably disposed to it."
Democrat Elisabeth Jensen, running for Congress in the 6th District, has run a radio ad embracing "Kentucky Kynect" and said, "It polled well." (
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