FRANKFORT, Ky. - More than nine out of 10 Kentuckians now have health insurance, but supporters of health-care reform in the Bluegrass State fear a murky future as Republican Matt Bevin prepares to take office as governor on Dec. 8.
Bevin has said he wants to shut down the state's health-benefits exchange, kynect, and transition to the federal exchange. He also wants to roll back Medicaid expansion, which has added more than 400,000 low-income Kentuckians to that program.
To Sheila Schuster with the Action Advocacy Network, rolling back Medicaid "makes absolutely no sense."
"What do you say to people, 'You're not worth getting healthy, you're not worth taking care of?' We had such a good deal, but we're going to say no to it? It makes absolutely no sense," she said, "financially, economically, in terms of business, in terms of the growth of our state, in terms of the health of our state."
Bevin said his intent is not to cut people off but to customize Medicaid to Kentucky through a waiver - known as a "1115 Medicaid demonstration waiver" - of federal rules on eligibility and coverage.
Bevin has pointed to Indiana's model as an example of the direction he wants Kentucky to head. Medicaid recipients there pay either premiums or co-pays, sometimes both. Ashley Spalding, research and policy associate for the Kentucky Center for Economic Policy, said that would tamp down access to health care.
"Research shows that even when premiums and co-payments are seemingly modest," she said, "low-income people are less likely to enroll, and they're less likely to seek needed care."
Gov.-elect Bevin said he isn't looking to make draconian moves. However, Spalding noted that tens of thousands of Kentuckians have received cholesterol screenings, mammograms and other types of preventive care since obtaining insurance through Medicaid expansion. She warned that rolling back expansion could slow down that trend.
"We could see fewer people accessing these preventive-care services," she said, "which, in the long term, we expect to increase not only the health of individuals but to increase the health of our state."
