Affordable Care Act

Rebecca Kiger

On a recent gray winter morning Tomas Green drove the rain slick streets of Ranson in West Virginia’s Eastern Panhandle. No matter the weather, Green helps transport clients working through addiction at the Jefferson Day Report Center get to their treatment sessions and meetings.

“If they need rides, I use my own personal transportation sometimes,” he said.

As a Peer Coach for the center, he strives to go above and beyond for the clients. Green can relate to his passengers: He’s in recovery himself.

His experience taught him recovery can be difficult. And now he wants to help others stay on the right path.

“For me, I share with everybody it’s good to have a good support system.”

Kentucky Hospital Assoc.

Since the expansion of Medicaid under the Affordable Care Act the health care sector has grown by more than 19,000 jobs in the Ohio Valley region. And some economists who focus on health care policy are warning that many of those jobs could well hang in the balance as Congress considers changes to the Act.

One of the ACA’s effects in the Ohio Valley region has been to sharply reduce costs for what’s called uncompensated care — that’s the cost of caring for the uninsured.

Dustin Pugel is an economist at the Kentucky Center for Economic Policy, a nonpartisan research center. He said in Kentucky’s rural hospitals there’s been about a $150 million decrease in uncompensated care costs just in the first quarter after Medicaid expansion. He worries that if the ACA is repealed more people will lose their health insurance, and hospitals will have to cover that cost again.

  

Stephen George

After President Donald Trump cited Gov. Matt Bevin’s claim that the Affordable Care Act is “unsustainable and collapsing” in Kentucky during his address to a joint session of Congress Tuesday night, former Kentucky governor Steve Beshear delivered the official Democratic response: Don’t dismantle Obamacare.

“You and your Republican allies in Congress seem determined to rip affordable health insurance away from millions of Americans who most need it,” Beshear said during his speech, which was broadcast from a diner in Lexington.

“Does the Affordable Care Act need some repairs? Sure it does,” Beshear said. “But so far, every Republican idea to replace the Affordable Care Act would reduce the number of Americans covered, despite your promises to the contrary.”

Alix Mattingly

Gov. Matt Bevin said Monday despite praise for Kentucky’s embrace of the Affordable Care Act in recent years, the initiative has been an “abject failure” in the state.

“Kentucky, which has long been vaunted as an example of the opposite, I’m telling you as a matter of fact has been an unmitigated disaster,” Bevin said at a news conference after governors attended an event with President Trump.

Bevin has long opposed the Affordable Care Act, which made more people eligible for Medicaid in Kentucky and created a state exchange, Kynect, for people to purchase health insurance.

Courtesy Mountain Comprehensive Care

Mike Caudill runs Mountain Comprehensive Care Corporation in five eastern Kentucky counties. Many of his 30,000 patients gained insurance through Medicaid expansion under the Affordable Care Act. No one knows if or when those folks might lose coverage. But, Caudill said, the impact could be considerable.

“I don’t want to be a Chicken Little that the sky is falling. On the other hand, neither do I want to stick my head in the sand,” he said. “A lot of it is the unknown. We don’t know what is going to happen.”

Caudill runs federally qualified health centers, providing primary and preventive care such as doctor’s visits and vaccinations. They also support community programs including a day care and a service providing fresh fruits and vegetables to 700 people who are chronically ill. If there are significant changes in his revenue because of a repeal of the ACA, Caudill said, those programs that improve the quality of life in the community would be the first to go.

Becca Schimmel

  Kentucky Senator Rand Paul, who  is pushing a plan to replace the federal Affordable Care Act,  Paul met with medical professionals at a Bowling Green hospital Monday to discuss his health care ideas.

Medical professionals gathered at TriStar Greenview Regional Hospital for an invitation only, town hall style meeting to hear details about Sen. Paul’s replacement plan. The Bowling Green Republican is proposing a tax credit of up to $5,000 per person to use as part of a Health Savings Account. His plan would also remove the Affordable Care Act’s mandate that every American get coverage.

J. Tyler Franklin

Kentucky Sen. Rand Paul introduced a bill to repeal and replace the Affordable Care Act on Wednesday that would do away with the law’s major reforms, including the requirement to have health insurance or pay a penalty and the ban on insurers refusing coverage for those with pre-existing conditions.

Under the proposal, people wouldn’t be required to get health insurance, nor would employers be required to offer it. Instead, groups of people and small employers could come together to form “independent health pools” to negotiate rates.

Gov. Matt Bevin’s administration is moving forward with a plan that would alter the state’s expanded Medicaid system, even if the Affordable Care Act is repealed or replaced by Congress.

The proposal has been billed as a way to get Medicaid recipients more involved in their healthcare choices and also a way to reduce Medicaid costs for the state. Bevin’s administration expects about 86,000 fewer people would be enrolled in Medicaid if the waiver is approved.

Vickie Yates Brown Glisson, secretary of the Cabinet for Health and Family Services, said on Wednesday that the state would still move forward with the plan, even if Congress moves to fully repeal the Affordable Care Act.

J. Tyler Franklin

At about 1:30 a.m. on Thursday, Republicans moved one step closer to repealing a law they have railed against since the moment it was passed nearly seven years ago.

By a final vote of 51-48, the Senate approved a budget resolution that sets the stage for broad swaths of the Affordable Care Act to be repealed through a process known as budget reconciliation. The resolution now goes to the House, where leaders are hoping to approve it by the end of the week.

The powerful tool sets up a fast track for repealing large parts of Barack Obama's major domestic achievement; the best guess is that the Senate is still several weeks away from largely repealing Obamacare. But as the process continues, large questions still loom over how — and when – Republicans will replace the healthcare law.

Six Lesser-Known Obamacare Provisions That Could Evaporate

Jan 11, 2017
Flickr/Creative Commons

The outcome of the repeal-and-replace Obamacare debate could affect more than you might think, depending on just how the GOP congressional majority pursues its goal.

Beyond the Affordable Care Act's marquee achievements like guaranteeing health coverage for people with pre-existing conditions and allowing children to stay on parents' plans until age 26, the roughly 2,000-page law created a host of other provisions that affect the health of nearly every American.

Some of these measures are evident every day. Some enjoy broad support, even though people often don't always realize they spring from the statute.

Rand Paul Might Stop An Obamacare Repeal. Here’s How

Jan 6, 2017
MSNBC

Kentucky Sen. Rand Paul said Wednesday that he would not vote to repeal the Affordable Care Act, known to many as Obamacare, without voting for a replacement plan on the same day. He made the comments on MSNBC’s “Morning Joe.”

“Here’s the great irony, this week we’re going to vote on a budget,” he said. “Everybody is hot and heavy to vote on this budget because they want to repeal Obamacare. But the budget they’re going to introduce will add $8.8 trillion to the debt over the next 10 years. So I told them look, I’m not going to vote for a budget that never balances.”

Lisa Gillespie

Vickie Sheehan is one of the lucky ones.

She gained health insurance in 2013 through the Affordable Care Act, buying coverage on the health exchange. Since then, Sheehan has undergone treatment for anal cancer.

“Everyone complained about Obamacare… to me, it saved my life,” Sheehan said.

She still feels that way. But this year, for the first time since the ACA, or Obamacare, was implemented, there are fewer choices for Sheehan and the more than 82,000 Kentuckians who get their insurance on the exchange. Fewer companies are selling insurance to these customers, and the lack of options means higher prices and fewer benefits.

Mark Wilson/Getty Images

Republicans in Congress say they'll vote to repeal much of the Affordable Care Act early next year — even though they don't yet have a plan to replace it.

But they also insist that they don't want to harm any of the millions of people who got their health insurance under the law.

The lawmakers' strategy? Vote to repeal, and fulfill their top campaign pledge. But delay the changes, and keep running Obamacare for as long as two years while they figure out how to fill the hole they'll create in the insurance market.

Creative Commons

A new study shows fewer Kentucky adults are delaying or skipping medical care because of cost concerns.

The report from the Foundation for a Healthy Kentucky says a little more than 20 percent of Kentuckians who are 18 and older put off treatment this year because they couldn’t afford it.

That’s a big improvement over the 32 percent who skipped or delayed medical care in 2009.

“It’s still too high a figure, and we’re still higher than the national average,” said Foundation President and CEO Ben Chandler. “But it’s certainly better than what it was, and it’s a good sign and a step in the right direction.”

Chandler says the increasing number of Kentuckians who have health coverage under the Affordable Care Act has made a big difference. He points out income level is also a big predictor of whether Kentuckians had to put off getting medical care.

Flickr/Creative Commons

If you go to the hospital this year, there will likely be a small decrease in your bill from previous years.

That’s because hospitals in Kentucky saw the lowest rates of charity care in 2015 since before Medicaid expansion went into effect four years ago.

But it might not last.

Charity care refers to the services hospitals provide patients who can’t pay because they don’t have insurance. Hospitals get paid back for this partially by the state and federal government, but they pass the remaining cost on to insured people.

In 2015, Kentucky hospitals had $552 million in charity care costs, compared with $2.4 billion four years ago.

The findings on uncompensated care come from a new report from the Foundation for a Healthy Kentucky report out last week.

A big reason for the dip is likely from the state’s expanded Medicaid program.

Pages