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Kentucky Shouldn’t Turn Its Back on Affordable Care Act Success

By Patrick Willard,


In horse racing, it is not a good idea to change jockeys when you have a winner. That is why Governor–elect Matt Bevin should not rush into a decision on Kentucky’s winning approach to health coverage.

Gov. Steve Beshear, term-limited to eight years in office, will be replaced by Bevin on December 8 at inauguration ceremonies in Frankfort. It was Beshear who created Kynect, the state’s health insurance marketplace that worked when was creating spinning beach balls on computer screens across the nation. And it was Beshear who issued the executive order that expanded the state’s Medicaid program, providing health insurance for some 400,000 low-income Kentuckians.

By all accounts, the expansion of health coverage has been a success. Since 2013, the population of Kentucky residents without health insurance has dropped from 20.4 percent to 9 percent. In addition, the number of prevention screenings for breast cancer and colon cancer in the state nearly doubled between 2013 and 2014.

Bevin will need to weigh these successes against his desire to rein in the Medicaid expansion and dismantle the Kynect health insurance marketplace. In the weeks since his election, Bevin has suggested he will take steps in 2016 to begin the process but has provided few details of how his plans will affect consumers.

Now that the election is over, Bevin has the time to do what he did before he entered politics: take a look at the business case and make a decision based on sound principles rather than sound bites. That means taking into account the costs to the state budget if Kentucky turns its back on Medicaid expansion now. Beshear estimates the state budget will come out $300 million ahead in the next two years because of the revenue from Medicaid expansion and budget savings.

But it is not just the economic case that the new governor should consider. Bevin must grapple with the impact an upheaval in the health care system would have on the state’slow-income workers and their families. As commentators have noted since the election, some of Bevin’s supporters include those who benefit from the ACA. Imposing harmful penalties and restrictions could mean fewer health screenings or preventive care for a population that is already at risk.

If Matt Bevin wants a winner, he needs to focus on the long run, not the sprint. A healthier Kentucky is the big prize, and the state is further down that road because of its health coverage today.