KY Policy Blog

130,000 Kentuckians in Individual Market Would Lose Coverage from Health Reform Repeal

By Dustin Pugel
January 26, 2017

A partial repeal of the Affordable Care Act would likely result in close to half a million people becoming uninsured in Kentucky, including those who buy health coverage directly from an insurance company. According to the Urban Institute, 130,000 Kentuckians who are individually insured would lose coverage. Because the ACA requires everyone to have insurance or face a penalty, a larger, healthier and younger pool of plan-holders has made it possible for insurance companies to cover people who have conditions that make them more expensive to cover like asthma, diabetes, read more

A County-by-County Look at Kentuckians at Risk if Congress Rolls Back Health Coverage

By Dustin Pugel
January 9, 2017

Nearly one in three Kentuckians has health insurance either through Medicaid or with a federally subsidized Qualified Health Plan (QHP) from the health insurance marketplace (formerly Kynect). If Congress moves forward with repealing the Affordable Care Act (ACA) and making big structural changes to the traditional Medicaid program, Kentuckians across the state are at risk of losing coverage or having it weakened. We’ve previously described how an ACA repeal would hurt state-wide, but county and regional impacts would vary.

The map below shows the share of Kentuckians that have insurance read more

How Criminal Justice Reform Would Help Kentucky Kids

By Ashley Spalding
December 22, 2016

Criminal justice reform is important not just for adults but also for children, as highlighted in a new report from the Economic Policy Institute (EPI). This link is especially relevant in Kentucky given the large share of children with a parent who has been incarcerated as well as opportunity to make needed changes given the momentum around criminal justice reform in our state. If fewer parents are incarcerated — particularly to serve very long sentences — their kids could see improvements in education, better health and more economic opportunities, the read more

Six Protections Kentuckians Will Lose if ACA Is Repealed

By Dustin Pugel
December 20, 2016

The patient protections provided by the Affordable Care Act (ACA) have enabled as many as 1.9 million Kentuckians to receive needed health coverage and care without falling victim to harmful insurance company practices. If these vital protections end through a repeal of the ACA, the effects would be widespread and dangerous, particularly for children, seniors and those with disabilities and chronic diseases.

According to a state-by-state analysis by Families USA, here is what is at stake in Kentucky:

1.9 million Kentuckians with conditions like asthma, diabetes, and cancer could be read more

Number of Uninsured Kentuckians Would Triple Under a Partial Health Reform Repeal

By Dustin Pugel
December 8, 2016

An estimated 486,000 Kentuckians would lose insurance coverage under a partial repeal of the Affordable Care Act (ACA), a tripling of the number of uninsured in the state, according to a new report from the Urban Institute. This decline would come from people losing Medicaid coverage, federal insurance marketplace (formerly Kynect) subsidies, the individual mandate and the individual insurance policy market.

The losses of coverage in Kentucky would be the third highest of any state.


The congressional plan to repeal the ACA, while delaying full implementation for two years, would read more

Comments to Washington on Proposed Medicaid Changes were 9 to 1 Against

By Dustin Pugel
October 12, 2016

The period to give input to the Cabinet for Health and Human Services (HHS) on Governor Bevin’s proposed changes to Medicaid ended last Saturday with a total of 1,749 responses. The responses were overwhelmingly in opposition to the changes the governor proposed and in support of the program as it currently exists, as shown in the graph below:


Source: KCEP Analysis 1 of Comments made to HHS on Kentucky’s 1115 Waiver Request (

After removing identical responses submitted from the same commenter, responses that weren’t related to the waiver request read more

A County-by-County Look at Potential Enrollment Decreases from Proposed Medicaid Waiver

By Dustin Pugel
September 1, 2016

The Governor is seeking to make changes to Kentucky’s Medicaid program in a way that would result in 87,639 fewer traditional and expanded Medicaid enrollees by 2021, according to official projections. This represents a total drop in enrollment of 6.6 percent from the starting point of October 2015. What does that mean across Kentucky counties?

The map below shows how many people would likely lose coverage in each Kentucky county if the enrollment drops were proportional to the traditional and expansion Medicaid population in counties. Enrollment drops are steepest in read more

Modest Savings from Medicaid Waiver Ignore Added Costs and Mostly Don’t Come from Expansion Population

By Dustin Pugel
August 31, 2016

The Bevin administration has submitted the revised version of its request to make changes to Kentucky’s Medicaid program and continues to tout the plan’s savings. However, projected state savings are only from covering fewer people, and those savings are small and don’t primarily come from the Medicaid expansion population, which is the portion of Medicaid the administration says we cannot afford. What’s more, savings diminish once the costs of a less-healthy population, the economic losses from fewer federal dollars into the state and higher administrative costs to operate the new read more

New Medicaid Waiver Plan Keeps Approach from Problematic Original Proposal

By Jason Bailey
August 24, 2016

The Bevin administration submitted its waiver proposal to the Department of Health and Human Services (HHS) today, keeping the problematic approach that was in the original plan with modifications in a handful of areas.  The proposal includes work requirements, premiums, lockout periods and other measures that would reduce the number of Kentuckians covered, some of which have been consistently rejected by the federal government in other state proposals.

The revised proposal includes the following measures:

Work Requirements for Participation

The plan includes a requirement that non-disabled adults without children engage read more

A Roundup of Recent Research on Kentucky’s Medicaid Expansion

By Dustin Pugel
August 15, 2016

Kentucky’s Medicaid expansion is building a strong foundation for a healthier state, and this is showing up in the research. When considering changes laid out in the recently proposed Medicaid demonstration waiver, it is important to keep in mind the evidence that backs the state’s current approach.

Kentucky’s current approach to Medicaid expansion is resulting in progress

A new study led by researchers at Harvard’s School of Public Health shows progress on a number of measures in Kentucky and Arkansas, another state that expanded Medicaid, compared to Texas, a state read more