Republicans wait for elections and chance to roll back Medicaid expansion; few Kentucky Democrats defend Obamacare

Though thousands of their constituents have benefited from it, Republican state legislators say they are planning to roll back Democratic Gov. Steve Beshear’s expansion of Medicaid under the Patient Protection and Affordable Care Act if they take control of the state House this fall or win the governorship next year.

In other words, the “wildly successful” rollout of the health-reform law in Kentucky has not changed the politics of it in the state, reports Louisville native Perry Bacon Jr., political writer for Yahoo! News.

Stivers and Beshear

Bacon starts his story by focusing on the home county of state Senate President Robert Stivers, a Republican from Manchester: “In one of the poorest areas of Appalachia, about 2,500 people have signed up to get health insurance over the last six months — a number that represents more than a tenth of Clay County’s residents. One hundred and twenty miles way, the county’s state senator, Robert
Stivers, is laying out his plans to gradually gut the Affordable Care
Act in Kentucky, which provided his constituents with insurance.”

Stivers acknowledged that the Medicaid expansion has benefited his neighbors, but told Bacon that it is “unsustainable” in the long run. For the first three years, the federal government is paying the entire cost of the expansion, but starting in 2017, the state will have to pay 5 percent, rising in steps to a cap of 10 percent in 2020.

Beshear cites a study showing that the expansion will pay for itself, largely by creating jobs in health care, and Health Secretary Audrey Haynes told Kentucky Health News that the expansion brought $45 million to health-care providers in the state in January, the first month it was in effect.

Republican Rep. Robert Benvenuti of Lexington, a former state health official, doesn’t buy the Democratic sales pitches. “I think it’s immoral to give you something you know we can’t pay for,” he told Bacon. “Why are
you creating dependency you know you can’t afford?”

Stivers suggested that Republicans could gradually reduce the income limit for Medicaid eligibility, now 138 percent of the federal poverty level, to reduce costs, but “The Obama administration has
long said it would not support such a partial expansion of Medicaid,” Bacon reports.

Also, “Some Republicans privately concede it will be difficult to roll back expansion of health insurance to so many,” Bacon reports, quoting a “top GOP operative” as saying, “Three hundred thousand people are on this now. It’s going to be hard to take this away from people.” And since that anonymous person spoke, the number is close to 400,000.

House Republicans tried to force a floor vote on Obamacare in the current legislative session, but Democrats foiled that through a parliamentary maneuver.

“Steve Robertson, chairman of the
Kentucky Republican Party, said the GOP statehouse candidates would run
this fall on the mantle of repealing the health care law, looking to
gain five seats and the House majority,” Bacon reports. “And a Republican could replace
Beshear,” who can’t seek re-election in 2015. Robertson said, “It’s a question of when, not if, when Kentucky will become just truly a red state.”

Bacon writes, “Democrats acknowledge the political challenge in defending the law. They
say the policy success has done little to shift the politics because
anything associated with Obama is unpopular in Kentucky. . . . The stories of the newly insured are drowned out, politicians in both
parties here say, by the enduring unpopularity of Obamacare and the man
it is named after, concerns (often unfounded) that the law has caused
premiums to increase for people who previously had insurance and general
confusion about the law, particularly the individual mandate” to buy insurance.

“Other than Beshear, many of the state’s leading Democrats, aware of the lingering tensions around the ACA, avoid speaking about it publicly, wary of being seen as too supportive of ‘Obamacare’,” Bacon reports.

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