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"Commonhealth" of Kentucky

All year long on Alabama Public Radio, we’re collaborating with to examine the Affordable Care Act.  When it comes to healthcare, Alabama has its problems. So does the commonwealth of Kentucky.  The difference is, the Bluegrass state is going about it differently and they seem to be getting results. 

Each state has large rural populations and each is considered poor. Alabama ranks near the bottom for median household income and Kentucky is not much better.  However, the similarities disappear when it comes to the Affordable Care Act.  When Washington offered expanded Medicaid funding, Alabama said “no” while Kentucky said “yes.” Kentucky’s governor Steve Beshear says it was an easy decision to make…

Every major player in Kentucky wanted us to do that. The Kentucky Chamber of Commerce, the Hospital Association, the provider networks, everybody said to me “Look, if we’re going to have a health benefits exchange, let’s do our own! We know better how Kentuckians react and what they need than the federal government, let’s come together and design our own exchange.”

Kentuckians have come out in droves, over four hundred-thirteen thousand of them have filled out forms on the state run website, fifty percent of whom are under thirty five. Governor Beshear says his state run internet marketplace worked while Washington struggled with its system.

We not only took the planning money, we also made out exchange fairly simple, we didn’t put a lot of bells and whistles on it. We made it easy to understand and use, we did extensive testing and then of course when October one rolled around and it opened up, we crossed our fingers and held our breath and of course it worked like a charm.”

Some people in Kentucky are glad the system seems to be working. Glenna Crockett works with senior citizens at the Rowan County Senior Center in Morehead Kentucky. She lost her health coverage and turned to the state system as her only lifeline.

I was informed by my employer, we’re a non-profit organization, that they could no longer afford to pay for out insurance. They got us in contact with a man who was supposed to help us. It took effect immediately as of January first and so far its worked out pretty good.”

Crockett says she is better off now than she was with her previous plan.

“My copay is actually cheaper than they was with my other insurance before, I didn’t have to pay any of my insurance, the company was paying it but they was paying twelve hundred a month, that’s my understanding for it. I have a small co-pay, its not that much with this insurance but my co-pays with doctor bills is cheaper than they was before and the insurance co-pay is about the same.”

However, not everyone is jumping for joy over what Governor Beshear did; Doctor Anthony Weaver teaches medicine at the University of Kentucky and hosts a radio talk show about health.

I can tell you why this is worst thing that ever happened to healthcare; the excess amount of regulation, the fact that there are more barriers between patients and doctors, the way they went about implementing it, slanting it against rural people and rural hospitals makes it, in my mind, very poor legislation.”

Weaver’s big worry is how to pay for it. Washington’s offer to fully cover Medicaid comes with a time limit. After three years, the federal money will be reduced, but the cost of healthcare won’t be. Weaver says Kentucky is going to have to pay the difference.

All the ways they said, on paper, that they would save money really are not going to pan out. It means it is still not sustainable, at some point we have to come to grips with that, that our healthcare system isn’t sustainable, wasn’t under the previous rules and guidelines and is not under the Affordable Care Act, that’s my opinion.”

Weaver admits though, the average Kentuckian is probably better off with the flawed system than the alternative, which is none at all.

Another bone of contention is how Beshear did it. Kentucky’s governor didn’t ask the state legislature. He just signed an executive order and it was done. Despite the political end-around, Beshear is getting support from his own party; that includes Democratic state senator Walter Blevins.

I’m glad our governor has that right to do those things. We have a divided government right now, the Republicans control the Senate, the Democrats the House. The governor went ahead on his own and did an executive order, didn’t need the legislature, we weren’t in session at the time. There has been some talk about trying to defund it by the Republicans but they don’t have the votes in the House so it’s kind of at a standstill.”

Blevins says even if the Republicans manage to do away with or change the law, the plan would still have done some good.

At least for three years some people are going to have some healthcare and maybe they can get them some preventative care and teach them how to take better care of themselves and maybe it will make a difference in the long run. Even if the program falls flat on its face, at least for these next three years it looks like we’ll have health coverage for a lot more people.”

This is where Kentucky’s political landscape is unusual. Their congressional delegation leans Republican and the state government is mostly Democratic.  Governor Beshear says doesn’t matter when it comes to healthcare.

“I don’t care whether you’re a Democrat or a Republican, forget the politics of this thing. Forget the name Obama and just think about your own people. Think about the health status of your own people; think about how you’re going to resolve that health status for the better. Think about how you’re going to raise up the people of your state, this is an opportunity to do it.”

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