Health care battle brewing between governors

Posted at 4:31 PM, Feb 11, 2016

FRANKFORT, Ky. (AP) — Kentucky's two most recent governors went to war over the state's health care system Thursday, raising the stakes in a battle that could tarnish the legacy of the Obama administration's health care law.

Former Kentucky Democratic Gov. Steve Beshear formed a tax-exempt organization that will pay for an online campaign he said will "educate voters" about Republican Gov. Matt Bevin's plans to make fewer people eligible for Medicaid and to dismantle a state program where some can purchase private insurance plans at a discount.

"Gov. Bevin is going to be held accountable," Beshear said, adding: "What's more important? Living up to a campaign promise that shouldn't have been made, or the health of the people of Kentucky."

Bevin said he was amused that Beshear "seems offended by the idea that I would keep a campaign promise," adding it "tells you a fair bit about ... why I won."

"It is a little unprecedented and a little sad, frankly, that after eight years (Beshear) is still scrambling for a sense of relevancy," Bevin said.

Beshear, who served two terms as governor and left office in December, created both programs via executive order. They were hailed by Obama and health care advocates as a model for how the Affordable Health Care was supposed to work. But voters seemed to reject both programs when they elected Bevin in November, who campaigned on the promise of eliminating them because they are too expensive.

Bevin said he will dismantle Kynect by the end of the year, transitioning the 85,000 people who use it to a similar federal program. And he is asking the federal government for permission to charge some of the more than 400,000 people who have insurance through Kentucky's expanded Medicaid program to pay a small premium in order to keep their coverage. If the federal government says no, Bevin has said he will repeal the expansion altogether.

A Gallup-Healthways survey, released last week, showed Kentucky leads the nation in the decline of its uninsured population. The survey, based on 500 interviews a day for nearly a year, attributed the decline to Kentucky's expanded Medicaid program and its state-based exchange.

A Deloitte study, which Beshear commissioned and paid for with public funds, concluded Kentucky would net a savings of $819 million by 2021 from its expanded Medicaid program.

"All of these organizations are not engaged in some kind of conspiracy to mislead the new governor," Beshear said. "And it is time that Gov. Bevin step up, if he continues to say this is not sustainable and affordable, and give us the evidence."

Bevin called Beshear an "armchair quarterback," and said he has too much free time. He has criticized the Deloitte study, noting it was based on an assumption of adding thousands of jobs. Instead, a report from the Kentucky Hospital Association last year said the industry has lost thousands of hospital jobs.

Of the $35 million it took to pay for the state exchange this year, $3.1 million of it came from plans sold on the exchange. The rest came from a tax on private insurance plans sold off the exchange.

"Ninety-eight plus percent of you are subsidizing" the 1 percent, Bevin said.

Beshear's organization, "Save Kentucky Healthcare," can raise unlimited amounts of money, but their primary focus has to be on social welfare issues. They can pay for partisan political ads, but only as a secondary activity.

Beshear could use the group to pay for ads to support the Democratic majority in the state House of Representatives, which could then work to block Bevin's agenda in the legislature. The Kentucky House is the last legislative body in the South still controlled by Democrats. But Republicans need just five seats to take control for the first time since 1920, setting up a contentious and expensive fall election season.

"We're going to take advantage of every option that a 501c4 organization has to advocate and to educate," Beshear said.