Adequate health care for all Kentuckians is an idea that seems to garner bipartisan support. The challenge is finding agreement on how to provide access to it.
The debate in the commonwealth has focused on two reforms implemented under the auspices of the Affordable Care Act by former Gov. Steve Beshear: expanded eligibility for Medicaid coverage and the state health insurance exchange Kynect. New Gov. Matt Bevin campaigned on ending Kynect and has tasked his administration with dismantling it as soon as possible. The governor contends the federal government’s HealthCare.gov website is fully capable of serving Kentuckians.
But proponents of Kynect say the state health exchange has worked well. A coalition of health care advocates and religious leaders gathered in Frankfort on Thursday to make that point and express their desire to keep the exchange.
Kentucky Voices for Health points out that the commonwealth is a national leader in reducing its uninsured population. In 2013 before the launch of Kynect, just over 20 percent of Kentuckians were uninsured. Now that rate is less than 10 percent. Kentucky is second only to Arkansas in terms of having the greatest reduction in its rate of uninsured adults, according to the most recent Gallup-Healthways Well-Being Index.
But if Kynect goes away, how will people sign up for private insurance or Medicaid?
While most Kentuckians can enroll through HealthCare.gov, the process for applying for Medicaid coverage has changed. Individuals seeking to learn if they qualify for Medicaid must now use a new website called Benefind. If the person does qualify for Medicaid, he or she will be enrolled. If not, they will be rerouted to HealthCare.gov.
Emily Beauregard, executive director of Kentucky Voices for Health, said Benefind, which has been proposed as a replacement for Kynect, is unable to handle the high number of individuals seeking help.
In addition to new sign-up procedures, another significant change will result from a shut down of the state’s health insurance exchange. According to Kentucky Voices for Health, Kynect has created over 600 jobs for state and contracted workers who serve as so-called Kynectors. They help individuals navigate the exchange and sign up for the insurance coverage that best suits their needs. Although Kynectors primarily help enroll Medicaid recipients, their services are available to anyone who applies for coverage through Kynect. They are essentially health care caseworkers
Those Kynectors stand to lose their jobs with the closing of Kynect. Cabinet for Health and Family Services Secretary Vickie Yates Brown Glisson told lawmakers earlier in the session that most of the contracts for Kynectors were due to expire soon, indicating that they would be looking for new jobs no matter what happened to Kynect.
Kynect proponents say the Kynector caseworkers provide a valuable service to impoverished and elderly Kentuckians who need help accessing the online exchange or selecting the appropriate coverage. They add that Kynect provides vital assistance to those with mental and behavioral health issues.
Cynthia Cain, a Unitarian Universalist minister, told the press conference on Thursday about her direct experience with how Kynect has helped those with an addiction secure insurance.
Senate President Robert Stivers (R-Manchester) spoke on the Senate floor Thursday about his concerns with the Affordable Care Act. He acknowledged that Kentucky has received national accolades for insuring people. But he expressed skepticism about the affordability of some of the plans.
On Tuesday the Kentucky House passed legislation to require the state to keep expanded Medicaid coverage and to operate a health insurance exchange similar to Kynect.
Follow @ReneeKET on Twitter for updates throughout the day, and for a recap of the full day’s activities, watch Legislative Update, weeknights at 11 on KET. You can also follow the Kentucky General Assembly on KET’s Legislative Coverage App for your smartphone or tablet.