Tuesday, January 19, 2016

Moderately Good News: New Kentucky Governor Now Admits He Cannot Unilaterally Dismantle Medicaid Expansion There

[First, a digression -- I was actually going to write tonight, about Martin Shkreli parting ways with his criminal lawyers -- but decided to save that for tomorrow. Much hilarity likely there, in my estimation, in the coming news cycles. Do be assured, though, this is a smart move by the very able lawyers at Arnold & Porter -- that guy is the quintessential toxic client.]

Where was I? Oh. Right. In our (very) occasional series of updates on how Obamacare is faring in the remaining open (red, mostly southern) states, I'll quickly mention Kentucky. It is ironic that the new Governor, Bevin -- a conservative who professes that he prefers local government over federal incursions, is forgoing a working local health care exchange, Kynect -- to foist his neediest citizens off onto the default federal exchange -- something he has repeatedly said is an inferior alternative. [But the 2016 bathtub of politics is literally overflowing with unintended irony, it seems.]

Ah hey -- why quibble about such. . . details? He is just in an entirely scorched Earth reactive mode -- bent on undoing anything our 44th President did, before Bevin arrived. Having said that, I think in the end, he will end up with a modified state exchange (his people will insist on it -- the ones who elected him).

I also think, in the end, the main victory here is that he realizes he needs federal approval to alter eligibility for the already in-place Medicaid expansion in Kentucky -- as those are now property rights vested in the recipients, by controlling federal law. So I am smiling, here. Just a bit, then from the Gray Lady:

. . . .Another point that defenders of Kynect make is that its annual budget comes entirely from a 1 percent assessment on all insurance premiums in the state, which existed even before Kynect opened to pay for another insurance program. The federal exchange places a 3.5 percent assessment on all plans bought through it.

They say the higher assessment from the federal exchange could make premiums more expensive. But Ms. Ditto said the federal exchange’s assessment would be fairer.

“The vast majority of Kentuckians are paying an assessment to support a website that they do not use,” she said. “This will ensure that the assessments are only applied to those using the exchange.”

Ms. Ditto said the Bevin administration did not anticipate having to pay back any of the $290 million in federal funds it received to build Kynect. But federal officials have suggested the state may need to repay $57 million the exchange has not yet spent. . . .

Be careful what you wish for Gov. Bevin -- the irony quotient here is rising, day by day. I'll have more, if and when he actually sends these people off to the federal exchange. But as I say, I'd still bet on a compromise on the generally well-regarded Kynect -- and a continuation of the Medicaid expansion in Kentucky. G'night, one and all.

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