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June 2012
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Kentucky's Medicaid expansion morally right



I'm accustomed now to critics' misleading statements about the Affordable Care Act, but a recent editorial in this newspaper was so breathtakingly disingenuous that it demands a factual response. That a newspaper of this size would trot out such unsubstantiated tripe disguised as analysis is a disservice to its readers.

If the writer had bothered to contact any member of this administration - or reviewed any of the information we have provided over the past year - (what's called "reporting") - we could have had a substantive discussion of issues related to getting health care to uninsured Kentuckians.

Instead, The Paducah Sun editorial board relied on biased national studies, long-outdated information, and outright deception to argue that Kentucky should turn its back on its citizens.

From the beginning I said that Kentucky should expand Medicaid only if it was affordable to do so. To answer that question, we commissioned independent reviews from PriceWaterhouse Coopers and the Urban Institute at the University of Louisville, and reported the results of those Kentucky-specific studies a year ago.

In fact, I submitted an op-ed to this very paper a year ago this week explaining the impact for our state and for the Paducah area. Since the paper both ignored the reports and apparently refused to run that op-ed, here's a refresher course on the actual facts.

Fact: Medicaid expansion helps the state budget. These reports concluded that Medicaid expansion would have a positive impact of $802.4 million on the state budget between 2014 and 2021. Without expansion, our budget would see a negative impact of nearly $40 million, because we would be forced to absorb costs such as increased payments to hospitals for uncompensated care. In other words, the state would lose money if we didn't expand. And yes, those calculations take into account the small increase in Medicaid matching funds the state will contribute beginning in 2017.

Furthermore, we have a safeguard: Kentucky and all states have the option of reversing the expansion of Medicaid in the future if it becomes unaffordable.

Fact: Paducah-area hospitals stood to lose millions in funding without Medicaid expansion. Paducah-area hospitals were already treating the uninsured at a financial loss. While they incurred nearly $5.5 million in costs for treating the indigent in 2013, they received only $2.1 million from state and federal funds to cover those costs - a loss of more than $3 million. And even those payments were going away, as the federal government is phasing out all support for indigent care.

Under Medicaid expansion, Western Baptist and Lourdes can expect to receive more than $10 million in annual Medicaid reimbursements for treating patients who had previously been uninsured. That doesn't count reimbursements from newly acquired private insurance.

Fact: Thousands of western Kentuckians have enrolled in health insurance - including private health plans. McCracken and surrounding counties had an estimated 21,000 uninsured at this time last year. Since October 2013, more than 9,000 people enrolled in health care through kynect, Kentucky's Health Benefit Exchange, including 3,700 who purchased private insurance plans. Some 75 percent of them didn't have insurance when they signed up. That drops the potential uninsured population in those counties from 16.5 percent to 6.5 percent - an astonishing reduction.

For most of these working families, health insurance was long out of reach. The Sun editorial board should meet some of these folks. They aren't waiting for a handout. They are usually the working poor, many of whom have more than one job, none of which provide affordable health insurance. For years, their low incomes or pre-existing conditions shut them out of health insurance. They rolled the dice and prayed that they didn't get sick, then chose between food and medicine.

And yet, The Paducah Sun would seem to prefer to keep these working families in a perpetual state of anxiety and fear, one bad diagnosis away from poverty or bankruptcy.

Under The Paducah Sun model, thousands of their neighbors stay uninsured, forcing taxpayers and insurance carriers to foot the bill for expensive emergency care â ¦ local hospitals lose millions of dollars each year in indigent care â ¦ and entrepreneurs defer plans to start new businesses because they can't afford to leave a dead-end job with health benefits.

That's not a Kentucky I believe in - nor one that is moving forward.

The bottom line is that bringing health care to the uninsured is the right decision morally and financially - for both our families and the state. Federal health care reform gave us the tools to shore up a failed health care system, to support local hospitals and health care workers, and to provide working families with the security they deserve.

Instead of continuing its war on west Kentucky families with its misleading campaign, The Paducah Sun should be celebrating that thousands of Kentuckians right outside its doors are finally benefiting from reasonable, affordable and accessible health care.

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