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Kentucky DisKynect
Author: Raine    Date: 11/05/2015 14:41:18

On election day, the people of Kentucky voted to elect Republican Matt Bevin as its next governor.

They also chose to re-elect Alison Lundergan Grimes as Secretary of State. For Attorney General Kentucky elected Democrat Andy Beshear . Mr. Beshear happens to be the son of outgoing Kentucky Governor Steve Beshear.

The incoming Governor campaigned to attract social conservatives in his state --- also known as the Kim Davis demographic.
The preliminary steps from the eight-year leadership of moderate Democrat Steve Beshear to Tea Party conservative Matt Bevin began behind the scenes and in a cooperative spirit.

But emotions are stirring about a candidate elected with a mandate Tuesday who has promised to cut the size of government, rework public pensions, initiate charter schools, adopt a so-called right-to-work law, blasted Obamacare and embraced the cause of Rowan County Clerk Kim Davis.

It seems pretty bad for the people of Kentucky, but it is important to keep in mind how important it was to elect a Democratic Attorney General in light of the radical changes that the incoming governor wants to make with regard to the expansion of medicaid and the state exchange -- known as the gold standard by many regarding the ACA. The new Governor defeated the state's CURRENT Attorney General, who said in September that he would continue Kentucky Kynect and the Medicaid expansion.

So what will incoming Governor Bevin do? It is hard to to tell to be honest.
But the biggest question to me will be how he chooses to address health care here. Bevin was adamant in February that he wanted to reverse Gov. Steve Beshear's (D) executive order that expanded Medicaid to 138 percent of the federal poverty level.

With more than 400,000 Kentuckians having signed up, that position was untenable in the general election, and Bevin repeatedly tried to walk it back.

He never hedged, however, on his pledge to shutdown Kynect, the state's health care exchange, and transfer those who signed up to the federal exchange.

After two years of being hailed as the nation's gold standard for "Obamacare" implementation, we might be about to find out how it looks when a state goes 180-degrees in the other direction.
He is going to try to get rid of it, but as this piece from TPM states, it is not going to be that easy.
Top health policy experts contacted by TPM the day after Bevin's victory weren't panicking or predicting a dramatic rollback of Obamacare in Kentucky. They were generally concerned about mischief Bevin could make at the margins, because any additional hassle faced by insurance customers can dampen participation. But experts watching closely said they were skeptical Bevin would be able to deliver a grave setback to the progress the state has made through its Obamacare programs.

“It is nearly politically impossible to take benefits from people -- even for Republicans,” Caroline Pearson, vice president of Avalere Health, an independent consulting firm and a top expert on health policy, told TPM. “I think that’s not likely to happen, even though that might sell well on the campaign trail.”
“To the extent that he wanted to disrupt things for people, that would be an option,” Rosenbaum said. The turbulence the transition would cause should not be understated, as users would have to learn a new system. But states are required to give the federal government a year’s notice before eliminating their own exchange, giving the feds time to smooth out the process.

“There’s no reason in terms eligibility why anybody should lose coverage, so the question would be, would they lose coverage because of some bureaucratic screw up in the transfer process,” said Timothy Jost, a health law specialist at the Washington and Lee University School of Law. “If they give a year’s notice, I think it should be feasible to make the transition and there shouldn’t be too much chaos.”

Bevin’s intentions for the Medicaid expansion are much murkier. He could roll it back entirely, as he at first suggested he would do. But in more recent interviews -- perhaps due to political blowback -- he has said he would alter the expansion instead.
He may want to rabble rouse, but with a Democratic Attorney General, son of the man behind creating the Gold Standard for the ACA, there will be pushback. I don't believe that state will be able to do much if anything regarding Obamare and medicaid expansion.

“Obamacare is here to stay,” Pearson said. “At this point it’s going to be about how you deliver that coverage more efficiently and sort of modifying the flavor a bit, but none of it’s going to disappear.”

The devil as always will be in the details, if the governor-elect gets his way and implements so-called right to work laws as he also campaigned on, you can bet that the importance of keeping Kentucky Kynect really is. Numbers don't lie.


His desire to break unions in the state are far more egregious than his bloviating about dismantling ObamaCare.



26 comments (Latest Comment: 11/05/2015 21:48:41 by Raine)
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