In the wake of last week’s gubernatorial election in Kentucky, the immediate future of health reform in the state remains unclear. Newly elected Gov. Matt Bevin (R), who opposes the Affordable Care Act, or ACA, has pledged to shut down Kynect, Kentucky’s state health insurance marketplace, and switch enrollees to the federal marketplace. Similarly, he also initially pledged to repeal Kentucky’s Medicaid expansion immediately after taking office. However, he backtracked in recent months on this second pledge, and lately, he has focused primarily on modifying the Medicaid expansion with a waiver from the federal government rather than repealing it outright.
Yet what is perfectly clear is that any ideologically motivated rollback of Kentucky’s successful health reforms would be a disaster. Repealing Medicaid expansion would blow a massive hole in the state’s budget, imposing a negative fiscal impact of up to $919 million over the next few years. At the same time, repeal would cause the state to miss out on the creation of 28,000 jobs and up to $30.1 billion in economic activity, as well as jeopardizing the 12,000 jobs that Medicaid expansion has already created. Furthermore, shutting down Kynect and switching to the federal marketplace would cost the state at least $23 million and raise premiums by up to 2.5 percent for Kentucky marketplace enrollees.
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