The disconnect between “Obamacare” and “KYnect” was one of the great paradoxes of American politics. In polls, Kentucky voters rejected “Obamacare” at roughly the rate they rejected the president, 2-1. But they were fond of KYnect, which Beshear created by executive order, bypassing a gridlocked Kentucky legislature. Month by month, Kentuckians took advantage of the state’s Medicaid expansion or the plans offered on the exchange, and the state’s uninsured rate plummeted from 20.4 percent to 9 percent. Beshear predicted that “the Democratic nominee will make this a major issue and will pound the Republicans into the dust with it.”
On Tuesday night, it was the Democrats eating dust. Attorney General Jack Conway, who was expected to replace Beshear, lost in a rout to Tea Party activist Matt Bevin. Conway defended KYnect; Bevin called it a disaster. While his prescription for changing it shifted, he ended
race with a promise to undo Kentucky’s successful experiment.
“I plan to use the open enrollment period in 2016 to transition people from the state-level exchange to the federal exchange,” Bevin told the Cincinnati Enquirer last week. “Once all are transitioned, I would shut down the exchange.” When it came to Medicaid, Bevin pledged to “repeal the expansion as it currently exists, and seek a Section 1115 waiver from the Center for Medicaid Services.”
Karyn Bruggeman (Oct 21):
“The goal would be to get a waiver approved prior to 2017, when the state starts to pick up our share of the Medicaid expansion,” [Bevin spokesperson Jessica] Ditto said. “However, that is a lofty goal, given all the moving parts and the need for insurance companies to develop new plans based on new standards.”
Bevin’s campaign stands by statements that they would repeal Medicaid expansion, but contrary to charges that they would kick 440,000 people off Medicaid immediately, Ditto said it should be noted that until that federal approval is granted for a waiver plan, the details of which they would hope to craft with the legislature and various stakeholders, “We would continue to operate under the current Medicaid construct so that people could stay covered.”
Ditto said the goal is that when those covered under Medicaid expansion go to re-enroll, they would be offered a new plan under a waiver agreement “that will require more skin in the game and that certain requirements are met to continue eligibility.”
Both Conway and the Beshear administration point to reports showing waiver plans like the ones Bevin’s proposing would result in higher costs and less extensive coverage, and Beshear himself says it’s one reason why he has been campaigning so hard to elect a Democratic successor.
The Daily Kos Elections liveblog from last night has more.
More politics and policy below the fold.