Kentucky is gaining much-deserved national attention for the initial success of Kynect, the state’s new health insurance marketplace. Since Kynect’s launch, 413,000 Kentuckians have signed up for coverage either through Medicaid or private plans. Kynect’s website has worked smoothly, and in a recent poll more respondents had a favorable impression of the new program than a negative one.
This last fact is quite a feat given that Kynect is the state’s version of the Affordable Care Act (ACA), which since its passage has been the target of millions of dollars in negative ads and misinformation. Kentucky stuck its neck out by implementing the ACA while other states in the South rejected it.
Now opponents of the law are starting to adjust their rhetoric in light of its success in getting people covered. Also spurring a shift is the popularity of measures like letting young adults stay on their parents’ plans until age 26 and ending discrimination based on pre-existing conditions.
While Kynect’s success is good news for the state’s health, it could also be the first step toward a new, uniquely Kentucky approach to solving problems. Values and goals at the heart of the program suggest a sensible agenda for other pressing issues facing our state.
For example, Kynect’s main purpose is to help people gain health insurance who couldn’t otherwise afford it through access to Medicaid and financial assistance to buy private coverage. It’s the program’s biggest success so far.
What if we looked at new strategies to help Kentuckians better afford other critical needs like higher education, housing, energy costs and retirement savings? More people would be able to build and retain wealth, which would have positive repercussions for the entire state.
A related Kynect assumption—cited in Governor Beshear’s announcement at its launch—is that by making Kentuckians healthier we will build a foundation for economic development. Too often, development policy is limited to gimmicky tax breaks that have questionable effectiveness in luring jobs. But real long-term economic strength comes from investing in a higher quality of life, including better health, greater levels of education and a modern infrastructure. What if that assumption drove our economic development plans?
Prevention is also a core value of Kynect. The American health care system is rightly criticized for being more of a sick care system; its strength has been in providing innovative—and expensive—treatment to people after serious problems have advanced, but it’s done comparatively little to prevent problems in the first place. With Kynect, we’re hearing stories of people going to the doctor for the first time in years to get treatment for lingering conditions before ending up in the emergency room.
What if we applied that same philosophy of prevention to investment in early childhood education, or to intervention in problems like heroin use before they become crises? In addition to improving lives, we would save money in the long run on remedial learning and incarceration.
An additional lesson from Kynect is the need to do what works, without bells and whistles and regardless of ideology. Emblematic of Kynect’s approach is its website, which works because it emphasizes simplicity and functionality over flash. The broader law cuts against the ideological grain by asserting government’s role in rooting out inefficiencies in the health market like the lack of care coordination and excessive insurance company administrative costs. What if the state were more committed to practical problem solving on other emotionally charged issues like energy policy or economic development in the coalfields?
There are political lessons here too: Governor Beshear’s determination and outspokenness on behalf of Kynect challenge common assumptions about what political leaders can and cannot do and say. That kind of leadership does what’s right for the majority of the state’s people and trusts that support will follow.
Granted, it’s still way too early in Kynect’s history to declare victory. There’s no question we’ll need further changes and improvements in our health care system to make it more affordable, efficient and effective. But that’s what government at its best does on all issues—takes actions to make progress based on a clear vision of a better future.
