In Depressed Rural Kentucky, Worries Mount Over Medicaid Cutbacks
For Freida Lockaby, an unemployed 56-year-old woman who lives with her dog in an aging mobile home in Manchester, Ky., one of America's poorest places, the Affordable Care Act was life altering.
The law allowed Kentucky to expand Medicaid in 2014 and made Lockaby – along with 440,000 other low-income state residents – newly eligible for free health care under the state-federal insurance program. Enrollment gave Lockaby her first insurance in 11 years.
"It's been a godsend to me," said the former Ohio school custodian who moved to Kentucky a decade ago.
...But Lockaby is worried her good fortune could soon end. Her future access to health care now hinges on a controversial proposal to revamp the program that her state's Republican governor has submitted to the Obama administration.
Baptist Health Plan to stop selling insurance in Ky.
FRANKFORT (AP) — Baptist Health Plan says it will not sell policies in Kentucky next year, meaning about 7,000 people will have to find a new insurance provider.
Kentucky’s fourth-largest insurer notified state officials in a letter. In a news release, state officials say company President James S. Fritz said Baptist Health Plan had enrolled more people than it planned and said federal risk assessments imposed by the federal Affordable Care Act are “unsustainable.”
The company’s insurance plans sold on the state’s health exchange will be good through Dec. 31. Plans sold off the exchange will expire March 31, 2017.
The news means next year people in 59 counties will have one insurance provider selling plans on the state health exchange. Off the exchange, most counties will have two options, state officials said.
When I ran Kentucky's average requested rate hike numbers for the individual market back in May, I came up with a weighted average of 23.8%, but also cautioned that the weighting was likely based on less than 50% of the total ACA-compliant individual market state-wide.
Since then, it looks like a couple of the carriers resubmitted their filings with slightly different average requests, although nothing major. In fact, even Aetna dropping off the exchange doesn't change much, since it looks like they only have around 400 enrollees there anyway (plus, Aetna says they're sticking around the off-exchange market in "most" of the regions they're bailing on next year). Finally, as far as I can tell, Kentucky is among the states that Humana is not abandoning (though they might be reducing their footprint there?).
Anyway, just moments ago, according to SHADAC, the Kentucky DOI has posted their approved rates for the individual market:
But a funny thing happened on the way to the governor's office: Bevin's anti-Obamacare rhetoric started to tone down as Election Day approached. And in the months since he's been chief executive of Kentucky,instead of ripping up Obamacare out of his state, Bevin is making alterations to how the law works there and leaving its core elements and benefits in place.
Not much to say about the bluegrass state...taken together, the 6 carriers offering individual policies in Kentucky appear to be requesting an average rate hike of 23.8%, ranging from Aetna's single-digits for a few hundred people up to Golden Rule's stroke-inducing 65% hike. One thing to note is that KY's total individual market was around 163,000 people in 2015, and is likely around 25% higher today (around 203,000), so over half of the market is likely missing from this table:
I wrote a lot about Matt Bevin during the Kentucky gubernatorial campaign last fall, as well as after he won the election, was sworn in as governor, and started doing his best to screw up stuff which wasn't broken. As you'll recall, when it came to the Affordable Care Act and the state ACA exchange (kynect), Bevin originally promised that he was going to kill the kynect exchange completely (even though there's no reason to do so, it's been operating smoothly for years and has excellent branding in the state) as well as killing the ACA Medicaid expansion (even though, again, it's been a huge success in the state at no cost to them so far and only pennies on the dollar going forward).
Hmmm...OK, I guess "as of today" means I need to make the "thru date" 2/04/16 instead of 1/31 or 2/01, but whatever; the point is that this is Kentucky's final official total.
Kynect's total was 81,121 as of 12/26, so they only added about 12,500 more since Christmas. 93,687 is only around 75% of the 125K I was expecting, and is over 12,600 fewer private enrollees than they had last year, making them one of only 8 states to drop their open enrollment total.
FRANKFORT, Ky. - Following through on a campaign pledge, Gov. Matt Bevin has notified federal authorities he plans to dismantle kynect, Kentucky's health insurance exchange created as part of the Affordable Care Act.
In a Dec. 30 letter to Sylvia Burwell, secretary of the U.S. Department of Health and Human Services, Bevin said he plans to wind down the state health exchange and transition Kentuckians to the federal site, healthcare.gov, to shop for insurance under the law also known as Obamacare.
When ass-half Matt Bevin was running for Kentucky Governor, he campaigned explicitly on wiping out the state's expansion of Medicaid to over 400,000 Kentuckians under the Affordable Care Act.
As election day actually approached, he began kind of, sort of walking this pledge back, making vague references to possibly shifting to some form of "waiver" version of Medicaid expansion, along the lines of several other states. These vary from fairly mild (small co-pays/nominal premium payments, as we have here in Michigan) to extremely confusing/complicated, as they have in Indiana:
If you take a look at the State-by-State chart, you'll notice that in addition to a few clarifications here and there, there are 5 states (well, 4 states +DC) all the way at the bottom labelled "NO DATA YET".
California insists, just like last year, on doing this weird thing where they release the number of new enrollees who have signed up on a fairly regular basis, but the number of renewals by current enrollees is kept a secret all the way into January. I have no idea why they do that, and it's pretty important given that we're likely talking about somewhere between 1.0 - 1.3 million people here.
On the other hand, at least they've posted data on their new additions. DC, Idaho, Kentucky, New York and Vermont haven't even done that much as of this writing.
Unlike the exchange QHP enrollments, which will always continue to be the heart and soul of this website (it's right there in the name, after all), I've kind of gotten away from trying to track Medicaid expansion on a granular level over the past few months. The main reason for this is that in many of the expansion states, they've simply maxed out on enrollees, and the numbers from week to week or even month to month are simply holding steady at this point.