Beshear often says the expansion has added 12,000 health-care jobs, but he cites a state-funded study, not actual numbers reported by federal agencies, which are lower. “Monthly government data show Kentucky’s ‘health care and social
assistance’ sector has picked up – gaining nearly 10,000 jobs since the
Medicaid expansion started in January 2014 through October 2015,” Otts writes. “But
that’s still short of the 15,509 jobs predicted by the model in 2015.”
The 12,000 number is a projection generated by an economic model that is too simplistic for such a complicated move as Medicaid expansion, a leading University of Kentucky economist told Otts. “Which one would you believe?” Ken Troske asked. “I know which one I’d believe.”
The figures cited by Otts come from the federal Bureau of Labor Statistics, which reports jobs figures monthly, to the nearest 100. Its data show that when “social assistance” is removed from the health jobs category, the state has gained 6,800 jobs since January 2014. Almost all of that gain had been in ambulatory-care facilities, such as clinics, and residential facilities such as nursing homes.
Hospitals have 1,200 more jobs than they had in January 2014 but 200 less than December 2013, the month before the expansion began. Hospitals have said generally that they have been helped by the expansion, but hurt by another aspect of federal health reform — cuts in Medicare payments — and the Medicaid managed-care system that the state began four years ago.
Hospitals’ poorer fortunes are illustrated by two charts prepared by University of Louisville economist Paul Coomes, one using BLS data that show hospitals losing jobs while other heath-care providers gained after the expansion, and recent, slight reversal of both trends. The other, using federal Bureau of Economic Analysis data, show how Medicare payments to Kentucky have remained relatively flat while Medicaid payments jumped after the expansion (labeled ACA).