Beshear to Bevin: Keep health care expansion
FRANKFORT, Ky. - Seeking to defend his signature achievement, Gov. Steve Beshear on Friday made an impassioned appeal to Gov.-elect Matt Bevin not to dismantle Kentucky's expansion of health care under the Affordable Care Act.
Armed with budget details, health statistics and economic forecasts, Beshear argued that the expansion under the law also known as Obamacare has been an economic windfall for Kentucky, bringing in nearly $3 billion in Medicaid money since 2014 and creating 12,000 jobs.
Over the next two budget years, Kentucky will come out $300 million ahead because of additional revenue from Medicaid and savings to the state, he said.
"Contrary to what people without the facts say, the facts say we can afford this," Beshear said at a news conference at the Capitol.
But Beshear, a Democrat, said economic gain isn't the only reason Bevin, a Republican, should continue the health care policies of his administration. Bevin should consider that hundreds of thousands of Kentuckians, some for the first time, have gained access to health coverage and now are able to get much-needed medical care.
"It's the moral and the ethical thing to do," Beshear said. "If you want to talk about it in religious terms, it's the Christian thing to do."
Bevin, a Louisville business executive, conservative Christian and newcomer to elected office, campaigned in part on curtailing Beshear's expansion of Medicaid that added about 400,000 people. He also pledged to dismantle kynect, Kentucky's health insurance exchange, which offers outreach and education about health coverage and an online site where people can shop for health plans.
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Friday, Bevin's transition office released a statement that said he is focused on forming his new administration and preparing the state's next two-year budget. But he has a "health care vision" for Kentucky that will encourage personal responsibility and access to quality, affordable health care, it said.
"Gov. Bevin has promised Kentuckians a fresh start and he is working every day to deliver on that promise," the statement said.
Bevin has said Kentucky has too many people on Medicaid - with the expansion, the government health plan covers about 1.2 million people - and that kynect is not necessary because Kentucky consumers could simply go to the federal website, healthcare.gov, to shop for insurance.
But with the campaign over, Beshear said Friday he hopes he can persuade Bevin of the value of the Medicaid expansion and kynect.
"We cannot throw away the progress we have made and start over just to make a political point," said Beshear, who at one point appeared overcome by emotion as he talked about the importance of Kentuckians' access to health care.
The health law has become a frequent target for Republicans who criticize it as too expensive and complicated. Political attacks associate it with President Barack Obama, who remains unpopular in Kentucky and many Southern states that have rejected benefits offered under the law.
But Beshear urged Bevin to look to the example of Ohio Gov. John Kasich, a Republican who overruled fellow Republicans in his state and accepted the federal expansion of Medicaid. Beshear quoted Kasich, a GOP candidate for president, who cited the Bible recently about his decision to expand Medicaid.
"There's a book," Kasich said. "It's got a new part and an old part. They put it together. It's a remarkable book. If you don't have one, I'll buy you one. And it talks about how we treat the poor."
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The Medicaid expansion covers people who earn up to 138 percent of the federal poverty level, or about $33,000 a year for a family of four.
The federal government pays 100 percent of the costs of the Medicaid expansion through 2016. In 2017, that drops to 95 percent, declining to 90 percent by 2020 and beyond. Kentucky would not have to spend more than it saves or takes in from Medicaid until fiscal year 2021, according to an outside consultant's study obtained by the Beshear administration
Health advocates hope to convince Bevin, who becomes governor Dec. 8, to weigh what they believe are the benefits to Kentucky before enacting any changes. Details Beshear provided Friday are a good start, said Emily Beauregard, executive director of the advocacy group Kentucky Voices for Health.
"I think he really cleared up a lot of misinformation and misunderstanding," said Beauregard, who attended the news conference along with many other advocates. "I do think that the data Gov. Beshear shared today will make a difference."
Beshear, in his first public appearance since the Nov. 3 gubernatorial election, cited what he said were Kentucky's enormous gains in public health under the Affordable Care Act, which included an expansion of Medicaid and creation of kynect, both implemented by him through executive order.
Beshear urged Bevin not to dismantle kynect, which has been hailed as a national success, noting it costs taxpayers nothing because it is financed through a surcharge on insurance plans. And it would cost at least $23 million in state money to dismantle it and shut it down, Beshear said.
"It works and it's not costing us anything," he said.
Beshear appeared with Lt. Gov. Crit Luallen, chairwoman of a group called Kyhealthnow that Beshear created in 2014 to monitor Kentucky's progress in achieving various health goals.
Luallen urged Kentucky not to falter in efforts to improve public health in a state with some of the worst health outcomes in the nation from ailments including cancer, diabetes and cardiovascular disease.
"While wonderful progress has been made," Luallen said, "the real test will be in continued sustainability of these efforts."
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Among the achievements they cited:
» Ninety percent of Kentuckians now have access to health coverage. Under kynect and the Medicaid expansion, Kentucky had the sharpest decline in the nation among people who lacked health insurance, dropping from 20.4 percent to 9 percent. Beshear noted that prior to the health expansion, 640,000 Kentuckians had no health coverage.
» More people are using health coverage for preventative treatment and screenings. The number of Kentuckians obtaining preventive dental care and screenings for breast and colon cancer doubled from 2013 to 2014, the first full year of health coverage under the new law.
» Smoking has decreased slightly and and Kentucky's obesity ranking declined from fifth in the nation to 12th.
» While adult smoking barely budged - about 26 percent of Kentuckians over 18 smoke cigarettes - Luallen noted that youth smoking has dropped from about 18 percent to 17 percent.
Luallen used the occasion to issue the final report of kyhealthnow. Its mandate was far broader than tracking gains under the Affordable Care Act, and it reviewed efforts to improve physical activity, cut smoking and reduce abuse and overdose deaths.
But Beshear and Luallen singled out the federal health law as bringing about the most dramatic changes.
"We are well on our way to achieving our goal of ensuring that even our most vulnerable citizens have the benefit of affordable health care," Luallen said.
Beshear said he and Bevin discussed the health care expansion among other items at meeting after the election. Beshear said he believes Bevin is willing to consider his arguments in favor of kynect and the Medicaid expansion although he made no promises.
"My impression is that he's willing to look at the data and the facts," Beshear said. "He's a business guy. That's what I'd encourage him to do, look at this from a business standpoint."
Contact reporter Deborah Yetter at (502) 582-4228 or dyetter@courier-journal.com.