Feds give OK to disconnect kynect

FRANKFORT, Ky. — Starting Nov. 1, Kentuckians will have to use the federal health exchange to shop for coverage rather than kynect, the highly praised state health exchange launched under former Gov. Steve Beshear.

Federal officials on Tuesday gave cautious approval to Gov. Matt Bevin's plan to dismantle the state health exchange launched in 2013 as a means for Kentuckians to shop for health insurance or enroll in Medicaid under the federal Affordable Care Act.

Bevin had pledged to shut down the state exchange he said was redundant and steer Kentuckians seeking  commercial health insurance plans to healthcare.gov. Kentuckians seeking Medicaid, the majority of people who obtained coverage through kynect, will use benefind, the state's new online enrollment system for public benefits.

While approving the plan, a top official with the U.S. Health and Human Services Department expressed concern about the impact of the transition on the about 500,000 Kentuckians who gained health coverage through kynect.

"We remain concerned that kynect's transition to the federal platform may disrupt the seamless system of coverage that kynect established,"  Andrew Slavitt said in a letter to Bevin.

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The changes "may result in confusion for Kentucky consumers," Slavitt's letter said. It said the federal government will "closely monitor" the changes.

The change represents fulfillment of a campaign pledge for Bevin, a Republican, who had vowed to dismantle the health initiatives of Beshear, a Democrat who took full advantage of the federal health care law of 2010 to create kynect and expand the state's Medicaid program.

Bevin spokeswoman Amanda Stamper said Tuesday the decision of federal officials was "not unexpected" because Kentucky had met federal goals for the changes.

"This transition will allow Kentucky to achieve substantial cost-savings while still allowing citizens to enroll in qualified health plans," Stamper said.

But it disappoints health care advocates who say it is likely to result in confusion and loss of coverage for many Kentuckians.

"It makes no sense to me," said Emily Beauregard, executive director of Kentucky Voices for Health, an advocacy group. "All the progress we've made over the past few years is going to be at risk."

Save Kentucky Healthcare, an organization founded by Beshear after he left office in December, also expressed disappointment in a statement Tuesday.

"It is disappointing that Gov. Bevin is once again putting his rigid, right-wing ideology ahead of the health and well-being of Kentuckians," it said.

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Kentucky, under the federal health law, achieved the sharpest decline in the nation in the number of residents without health coverage.

U.S. Rep. John Yarmuth, a Louisville Democrat, said Tuesday that kynect has been "the most successful state-run exchange in the nation."

"Gov. Bevin's decision to abandon this national success story will jeopardize coverage for tens of thousands of residents, increasing costs and leaving them with far fewer plan options," Yarmuth said.

Still pending is Bevin's proposal to scale back the expansion of Medicaid that Beshear enacted under the federal health law.

The changes allowed anyone under 138 percent of the federal poverty level, an annual income of about $16,200 for an individual, to enroll in the federal-state health plan. It previously was limited largely to very poor pregnant women, children, the disabled and low-income elderly in nursing homes.

Under the expansion, Kentucky's Medicaid program grew from about 875,000 to 1.3 million enrollees.

Bevin is seeking the federal government's permission for a "waiver" that would allow him to reshape the Kentucky Medicaid program he has said is not sustainable.

Among changes aimed mostly at "able-bodied adults," people would be required to pay monthly premiums, could face a "lock-out" of coverage for failure to pay, and would be required to work or volunteer up to 20 hours a week to keep Medicaid coverage.

It also eliminates dental and vision coverage from basic benefits, though people could earn points to pay for such care through a "My Rewards" card.

Bevin has said the plan would create more personal responsibility among people covered by Medicaid.

But advocates have criticized the changes as unnecessary and overly complex.

Contact reporter Deborah Yetter at (502)582-4228 or dyetter@courier-journal.com.