Last week the Sun published a picture of Health and Family Services Secretary Audrey Haynes holding a sign aside a beaming Gov. Steve Beshear proclaiming that 413,410 people have enrolled in Kentucky's Obamacare program. We suspect the reason Beshear is joyous is because he knows it will fall to a future governor to deal with the financial mess he has created.
As an Associated Press report about the event noted, "About 80 percent of those 413,410 people have their health insurance through Medicaid, meaning that state and federal government pays for their health care."
Put another way, Kentucky increased its rolls of people receiving free Medicaid by 333,728. Only 82,682 people signed up for subsidized private health insurance under the program.
On the Medicaid side of the equation, the due bill for expanding Kentucky's program by another 333,728 comes in 2017, when the 100 percent federal government payment for the cost of those Kentucky enrollees ends. From that point Kentucky's share will rise over a few years to 10 percent of the bill, with that margin likely increasing further in future years due to federal budget constraints.
Think that's not a significant amount of money? Gov. Beshear, back at a time when he was candidate Beshear, told our editorial board he had "no idea where we would get the money" for Medicaid expansion if the Affordable Care Act was passed. He still doesn't.
Medicaid in 2012 already consumed 22.5 percent of the state budget. Data from the Kaiser Commission on Medicaid and the Uninsured showed that Kentucky was spending more than $5.2 billion a year on Medicaid as of 2009, $5,890 per enrollee. That math suggests Kentucky's total Medicaid spending will go up some $2 billion if 333,000 or so people have been added to the Medicaid rolls. How much will Kentucky's share of that be? A Heritage Foundation study last year suggests that even when savings from ACA managed care features are added in, the expansion will cost Kentucky an additional $846 million between 2014 and 2022.
Any way you slice it, it's going to be a big additional expense foisted on the state's already overburdened taxpayers. And as the Associated Press article also notes, many of those taxpayers - those with private health insurance - are going to take a hit in their premiums as well. The AP cites a survey by Morgan Stanley of six Kentucky insurance brokers that found in 2014 alone, the ACA was largely responsible for pushing individual health insurance premiums up by 29 percent in Kentucky.
Those ratepayers may find irony in the fact that Gov. Beshear at his celebratory event trotted out as a "success" a woman named Beth Moore, who left her job and the health insurance that came with it to start her own company. Self-impoverished, she bought subsidized insurance on the - shall we call it Obamashear - website and says when she then needed an appendectomy and later battled pneumonia she never paid more than $150 for treatment under her new taxpayer/ratepayer-subsidized policy.
Perhaps Kentucky should change the motto on its license plates from "Unbridled Spirit" to "Kentucky, where I work so others don't have to."
One thing is for sure - when the majority of Kentuckians who don't qualify for the governor's free or subsidized insurance giveaway feel the full bite of the premium increases, reduced services and higher taxes it will generate, Gov. Beshear's legacy will not be one that is fondly remembered.