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Kentucky's Success Makes a Mockery of GOP Obamacare Foes

October 3, 2013

Wednesday's Wall Street Journal provides the perfect encapsulation of the conservative crusade against the Affordable Care Act. On the opinion pages, columnist James Taranto mocked the story of new Obamacare enrollee Brendan Mahoney. But where news is actually reported, the WSJ's Arian Campo-Flores explained "Why Kentucky's Health Exchange Worked Better Than Many Others." But the Bluegrass State didn't just provide a relatively smooth first-day enrollment experience. As it turns out, one of the only reliably red states to both establish its own health care exchange and accept the expansion of Medicaid to low income residents, Kentucky is already proving Republican critics of Obamacare wrong.

Those critics include Mitch McConnell and Rand Paul, Kentucky's Republican Senators who were caught on a live microphone in Washington admitting their real motives is shutting down the government over the implementation of the Affordable Care Act. But back home, things are going pretty well for Kentucky's uninsured seeking to obtain coverage at Kentucky's Kynect exchange:

While Kentucky's health-insurance exchange experienced some glitches when it launched Tuesday, it seemed to perform better than many of its peers.
State officials and outside experts attribute the smoother rollout to a variety of factors, including intensive testing of the system, a less-flashy but more-efficient website and strong coordination among state agencies involved in the effort.
As a result, Kentucky's exchange, dubbed Kynect, logged solid results in the first day and a half of operation. As of 4:00 p.m. Wednesday, 10,766 applications for health coverage had been initiated, 6,909 had been completed and 2,989 individuals or families had enrolled in new coverage.

As the Journal suggested, Kentucky's success may be in large part to the experience of state agencies working closely together on other health care systems in the recent past, including a prescription-drug monitoring database. But the biggest factor of all is Democratic Governor Steve Beshear, who early on opted to have Kentucky run its own health care marketplace and accept billions of dollars of essentially free money from the federal government in order to expand Medicaid to cover 308,000 lower income working residents. In a recent New York Times op-ed, Governor Beshear explained why "My State Needs Obamacare. Now":

There's a huge disconnect between the rank partisanship of national politics and the outlook of governors whose job it is to help beleaguered families, strengthen work forces, attract companies and create a balanced budget.
It's no coincidence that numerous governors -- not just Democrats like me but also Republicans like Jan Brewer of Arizona, John Kasich of Ohio and Rick Snyder of Michigan -- see the Affordable Care Act not as a referendum on President Obama but as a tool for historic change.
That is especially true in Kentucky, a state where residents' collective health has long been horrendous. The state ranks among the worst, if not the worst, in almost every major health category, including smoking, cancer deaths, preventable hospitalizations, premature death, heart disease and diabetes.

That "rank partisanship" has left many in Beshear's state misinformed and confused. When 53 year-old Carolyn Richards of Mount Sherman, a woman who has been uninsured for a decade, visited a Kynect information booth at the recent Wild Turkey Sit N' Sip Saloon at the Kentucky Bourbon Festival, she was surprised to learn about her options under the Affordable Care Act:

"I thought this was defunded."

As the Washington Post also reported:

Sharon Omstead, 46, who works at a factory labeling bourbon bottles and who calls Obama "the devil" for his economic policies, was surprised to learn that she'll qualify for Medicaid and have to pay little or nothing for health coverage under the law.
"I'd heard a lot of bad things about the law and how it will make prices for health insurance go up, and how everyone will have to buy insurance even if they can't afford it," she said.
Pam Lux, 59, of Edgewood complained about insurers turning her away because of her diabetes and assumed that that would happen again until a Kynect worker informed her that such exclusions are prohibited under the law starting next year. "I'm glad to hear that," she said.

If that kind of story from the Bluegrass State sounds familiar, it should. In August, Huffington Post documented the same pleasantly surprised reaction from attendees at the Kentucky State Fair:

A middle-aged man in a red golf shirt shuffles up to a small folding table with gold trim, in a booth adorned with a flotilla of helium balloons, where government workers at the Kentucky State Fair are hawking the virtues of Kynect, the state's health benefit exchange established by Obamacare.
The man is impressed. "This beats Obamacare I hope," he mutters to one of the workers.
"Do I burst his bubble?" wonders Reina Diaz-Dempsey, overseeing the operation. She doesn't. If he signs up, it's a win-win, whether he knows he's been ensnared by Obamacare or not.

Ensnared, that is, into finally having access to health care in a state ranked 45th by the Commonwealth Fund.
Meanwhile in Republican-dominated states like Texas, Florida, North Carolina, Georgia and more, the GOP has manufactured a "coverage gap" ensuring that millions of their residents will needlessly be left without health insurance next year. But as Governor Steve Beshear shows, it doesn't need to be this way. As Mark A. Rothstein, a professor of law and medicine at the University of Louisville put it:

"If the law can go in Kentucky, it can go anywhere."


Jon Perr
Jon Perr is a technology marketing consultant and product strategist who writes about American politics and public policy.

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