Low-income workers say to keep Kynect and Medicaid expansion; advocates wonder how new insurance exchange will work

By Melissa Patrick
Kentucky Health News

As Republican Gov. Matt Bevin’s administration moves forward with plans to dismantle Kynect, the state’s health insurance exchange, several working Kentuckians shared stories at a news conference March 8 about how having affordable health insurance through Kynect and expansion of Medicaid has changed their lives, and asked the governor to reconsider his decision.

Jesus Gonzalez and Troy May

“For working Kentuckians in particular, Kynect is much more than just a website. It is a one-stop-shop for coverage that allows workers, students and caregivers an easy and seamless way to not only enroll in coverage, but to move easily between Medicaid and private insurance as their incomes fluctuate,” said Emily Beauregard, executive director of Kentucky Voices for Health, an umbrella group of health-care lobbying organizations.

Beauregard said that contrary to popular belief, most newly insured Kentuckians are low-income workers who didn’t have health benefits.

One of the part-time workers from Covington, Troy May, who is also a full-time graduate student at Cincinnati Christian University, explained how getting insurance through a qualified health plan on Kynect has allowed him to pursue a new career, work part-time and also care for his 90-year-old grandmother. He said federally subsidized insurance from Kynect “fills in the gap” between his life now and when he will eventually work full time and get work benefits.

“Every time that Gov. Bevin talks about dismantling Kynect,” May said, “it’s like a punch in the stomach.” He said the same coverage he gets on Kynect will be $200 more a month, with higher deductibles and co-payments on the federal exchange, which he says is not affordable.

“So this idea that we can easily move to a federal exchange and it not impact Kentuckians negatively is just flat out wrong,” he said, adding later, “I beg Governor Bevin and the Republicans in the state not to dismantle Kynect.”

May said he is a Democrat who comes from a family of Republicans, many of whom have signed up for health insurance through Kynect and have asked him, on their behalf, to ask Bevin to reverse his decision.

Another worker, Jesus Gonzalez, a single father and a food server in a Lexington restaurant, signed up on Kynect for the Medicaid expansion, which allows those with incomes up to 138 percent of the federal poverty line to enroll. He said that he had not had health insurance for the past 10 years because he couldn’t afford it and shared stories about the “peace of mind” he now has because he can go to the doctor and the dentist. He said this has “made a huge difference in my life.”

“It is really important that we do what we can to save and keep Kynect and Mediciad expansion in Kentucky,” Gonzalez said. Bevin has said the expansion won’t be sustainable once the state has to start paying a small part of the cost next year, and is negotiating changes in the program with the federal government.

The conference was sponsored by Keep Kentucky Covered, a coalition that is focused on sustaining access to affordable health coverage in Kentucky through Medicaid expansion and Kynect.

Pleas to save Kynect are likely falling on deaf ears. Bevin campaigned on closing Kynect, and has said it is redundant because there is a federal exchange that does the same things.

Advocates argue that Kynect provides one website to sign up for subsidized insurance and Medicaid, while Bevin’s new model will require two websites, one called Benefind for Medicaid and other public-assistance programs, and the HealthCare.gov for federally subsidized insurance.

Health Secretary Vickie Yates Brown Glisson told a House budget subcommittee last week that the state would move to a “supported state-based marketplace” that will allow it to keep some control over review of insurance plans and handle insurance-company grievances, but the actual enrollment and any consumers’ eligibility appeals will be handled by the federal exchange. Consumer grievances will be handled by a state-federal partnership.

Glisson said she didn’t know how many Kynectors, or health-insurance navigators, will remain. Beauregard and Rep. Joni Jenkins, D-Louisville, chair of the House Budget Review Subcommittee on Human Services, voiced concerns about the abilities of local offices of the Department of Community Based Services to handle the 1.3 million Kentuckians on Medicaid.

“They are already overburdened and overwhelmed with the amount of work that they are doing and facing budget cuts,” Beauregard said. “I worry that people are going to have a harder time getting enrolled in coverage and keeping their coverage, and getting the assistance they need when they run into an application problem or need to ask a question.”

Wait times at DCBS offices average 2 hours and 44 minutes, while wait times at the Kynect call center are 2.15 minutes, according to the education and outreach director at Kynect, Beauregard said.

Jenkins voiced the same concerns in a separate interview, also noting the importance of Kynectors who not only help people sign up for health insurance, but also help them access health care after they sign up.

“I would hope that our state’s goal was to not only get people signed up, but (to also) connect them with health care,” Jenkins said. Later adding, “I find it so interesting that we are going to do away with a Kentucky-made product that is working so well, that pays for itself, and that was paid for by federal dollars and it’s like letting big brother come down and — so, that is very interesting,”

Glisson told the subcommittee that she believed there would be some funding for Kynectors. She also said the county-based employees of her cabinet could help people get to the federal exchange if they don’t qualify for Medicaid.

But even if some Kynectors are included in this new model, the number of them will be determined by the number of people on the federally subsidized plans, and not include funding for Kynectors to help those on Medicaid, Beauregard said, “so you will also see a difference in the level of service you get if you enroll in Medicaid verses enrolling in a private plan,” she said.

“What is really important right now is to ensure that we have an enrollment system that works as well or better than Kynect moving forward for all of the Medicaid recipients in Kentucky,” Beauregard said. “And what that means is that we have to make sure that we have the capacity, whether that be at the Kynect call centers or in DCBS, to help these individuals enroll in coverage and to make sure that we are not creating barriers that translate into our uninsured rates going higher again or people loosing access to the care that they critically need,”

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