Op Ed: Health Care Law Will Benefit Kentuckians In Many Ways

Published in the Lexington Herald-Leader July 10, 2012.

The Supreme Court’s decision that the health care reform law is constitutional has not brought an end to ideological attacks on the law and calls for its full repeal. Now, Republican leaders in the legislature have announced opposition to state participation in the law’s Medicaid expansion as well as to the creation of a state-operated, private insurance marketplace called an exchange.

But if you sift through the claims about health care reform and look at the facts, the benefits to Kentucky are clear. Here are five reasons Kentucky should move forward with the new law.

It will provide more than 400,000 Kentuckians with health insurance.

The Affordable Care Act will drastically reduce the number of Kentuckians without insurance — currently about 15 percent of our population. About half of the newly insured will gain coverage through the expansion of Medicaid, while the rest will receive tax credits to buy private insurance through the exchange. Nationwide, more than 30 million Americans will gain health insurance because of the law.

It will protect consumers.

The law will prevent insurance companies from denying insurance to someone because they have a pre-existing health condition. This protection is now in place for children, and will apply to adults starting in 2014. It also will stop insurance companies from cutting off benefits to people with costly illnesses and charging higher premiums to women or sick people.

It will pay almost all of the cost of expanding coverage.

The federal government will pay 100 percent of Kentucky’s costs for the first three years of the expansion of Medicaid to low-income adults, and will phase down its share to 90 percent for 2020 and after. That will bring about $11 billion in federal money to Kentucky over the first six years of the law — investment that will show up in jobs for nurses and other health professionals providing care to the newly insured. The law will also provide $3.7 billion in tax credits over the first six years that Kentuckians can use to buy health insurance in the newly formed exchange.

It will result in deep savings in money now spent on the uninsured.

Because the law will reduce the number of people without insurance so dramatically, Kentucky will save money that state and local governments now spend on emergency room and other care, including mental health services, for the uninsured. Hospitals and clinics also pay some of these costs, as do consumers in the form of higher insurance premiums. The Urban Institute estimates that in Kentucky the state’s resulting savings will actually exceed the small additional state costs of expanding Medicaid — by between $140 million and $828 million over the first six years of the law.

It takes key first steps toward slowing growth in health care costs.

The law includes measures that begin to address the serious problem of growing health care costs. It reduces wasteful subsidies to private insurers in Medicare. It rewards health care providers for improving care in ways that lower cost, such as incentives for doctors and others to coordinate patient care.

The law also rewards hospitals that reduce infections and cut back on costly readmissions. And it puts more emphasis on primary and preventive care. More must be done to address the issue of cost growth, but the law takes the first steps in the right direction.

The existing health care system is simply not working in Kentucky. Health insurance is becoming less affordable, and fewer Kentucky workers can get coverage through their employers — while 70 percent of Kentucky workers did so in 1980, only 56 percent do today.

Our state’s residents struggle with above-average rates of diabetes, cancer and other health problems. Kentuckians don’t receive enough preventative and primary care, and end up with costly chronic health problems. And 640,000 Kentuckians simply do not have health insurance at all.

The law is a substantial opportunity to make progress in addressing the moral crisis of the uninsured while improving the health of our residents. Economically, it is a very good deal.

It’s important for Kentucky’s decision-makers to put aside political goals and ideological assumptions, and move forward to implement the law.

College Graduation Gap Widens for Low-income Kentuckians

Report Estimates Medicaid Expansion Could Actually Save Kentucky Money

We previously reported (here and here) that the state will likely incur little cost associated with the expansion of Medicaid beginning in 2014 to around 300,000 Kentuckians. But in fact the expansion could actually save the state between $140 million and $828 million over the first six years of the law, according to a report by the Urban Institute and the Robert Wood Johnson Foundation.

The report estimates that the expansion of Medicaid to adults with incomes up to 138 percent of the federal poverty level will cost Kentucky $547 million over the years 2014-2019.

However, expanded Medicaid coverage and the increase in coverage through a new health insurance exchange will result in a big drop in the number of uninsured. That will mean a huge reduction in monies the state spends on uncompensated care for the uninsured, such as emergency room treatment in hospitals. The report puts those savings at between $687 million and $1.375 billion over the years 2014-2019. And those numbers don’t include savings in mental health spending for the uninsured now paid by the state, which will also decrease.

The net result is between $140 million and $828 million in state savings over that six year period. For that, Kentucky would get between $12 and $13 billion in additional federal money. Most importantly, it will mean a big step forward in addressing the moral, economic and health crisis of the uninsured.

Those who propose that Kentucky should reject the expansion, which the Supreme Court ruling on health reform makes possible without a loss of existing Medicaid funds, should explain why Kentucky should turn down such a good deal.