Affordable Care Act

January was a miserable month for weather, but the wintry blasts in much of the country weren't enough to stop people from shopping for health insurance.

More than 1.1 million people signed up for coverage through state and federal health exchanges in January, according to a just-released report, bringing the total to just shy of 3.3 million people.

Now that the problems with the balky HealthCare.gov website are largely fixed, the Obama administration is finally feeling comfortable enough to launch some of the outreach it planned for last fall.

Its top target: young adults, specifically those between 18 and 35.

The Kentucky Access program is closing to make way for the Affordable Care Act.

The 14-year-old program was created to provide affordable health coverage to high-risk Kentuckians. It's ending because of a provision in the ACA that requires insurers to provide coverage to those people  regardless of pre-existing conditions.

Louisville Rep. Steve Riggs sponsored legislation that created the program in 2000. He says Kentucky Access isn't needed now that the ACA is implemented.

“It’s redundant, yeah. Duplicative. So that’s why the Department of Insurance is phasing it out, because now you can get that same type of coverage with the ACA, with Kentucky KYnect, and in many cases I understand it’s less expensive."

Kentuckians who obtained insurance through the program will now have to sign up for coverage under the state’s health insurance exchange, KYnect, before April or they will face tax penalties.

At its peak, Kentucky Access enrolled about 4,800 people.

Kevin Willis

Kentucky's Second District Congressman believes the problems with the rollout of Obamacare make it more likely major changes will be made to the law.

Bowling Green Republican Brett Guthrie is sponsoring a ten-point bill that includes the repeal of the Affordable Care Act.

Speaking Friday to a gathering of area business leaders, Guthrie said while a repeal isn't likely, the public is getting a glimpse of the problems related to greater government involvement in health care.

Guthrie also said Republicans missed an opportunity to highlight those points when the federal government was shut down.

"I think what would have been better for us, as the government shutdown was happening is not just, ‘let’s repeal Obamacare, and if not the government shuts down.’ Why don’t we say, ‘here’s our alternative to address people in the insurance market that are being priced out of the market without affecting it for everybody else.'”

Since the Affordable Care Act's health care exchanges launched to a long series of error messages Oct. 1, most of the "what went wrong" fingers have been pointing at software developers.

But some say there's more to it than that — that politics has played a role as well.

Remember how that fight over the budget was all about Obamacare?

Seems like ancient history now, but House Republicans ostensibly shut down the government 17 days ago, demanding first a defunding, and, when that failed, a year's delay in the health law.

  More than 16,000 applications for health insurance have been started in Kentucky since enrollment began this week under the state's new online marketplace, prompting Gov. Steve Beshear to declare that the state has become the "gold standard" for implementing the federal health care overhaul. 

The governor's office said nearly 11,000 applications had been completed by early Friday, and 4,739 individuals or families had picked health plans and signed up for coverage.

More than 137,000 people had browsed the website and 93 percent of them went through pre-screenings to determine if they qualify for subsidized coverage or Medicaid.

Also, 166 small businesses had started applications for health insurance for employees, it said.

"That tells me that there is not only a pent-up demand, but there is an eagerness to get affordable health insurance," Beshear said.

Kentuckians who sign up before Dec. 15 will start receiving coverage on Jan. 1.

The Department of Health and Human Services released insurance premium prices for federally-run exchanges today, including Tennessee, showing premiums in some states are lower than initially estimated.

But Kentucky’s exchange called kynect is state-run and wasn’t on that list.

Kynect has released the actual costs and range of plans for certain hypothetical situations. Kentucky Cabinet for Health and Family Services spokesperson Gwenda Bond says people can find out their individual costs beginning Oct. 1, which is the first day to apply for open enrollment.

Bond says all but 50,000 of the more than 600,000 uninsured Kentuckians will qualify for either the Medicaid expansion or premium subsidies through kynect.

Sen. Mitch McConnell and Gov. Steve Beshear squared off in a heated debate about the federal health-care law at the Kentucky Country Ham Breakfast.

The Democratic governor said Thursday the Affordable Care Act will work in Kentucky.

Beshear said the law will improve Kentucky's health problems, which include some of the nation's worst rates for cancer, heart disease and diabetes.

McConnell, the Senate's top-ranking Republican, said the law is driving up health insurance premiums and forcing employers to reduce working hours for many employees. McConnell said the law should be repealed.

Kentucky Senator Rand Paul says while he wants Republicans to continue fighting for changes in the President’s health care plan, he doesn’t support a shutdown of the federal government.

Some member of the GOP say they’re willing to risk a shutdown in an effort to defund the Affordable Care Act. Sen. Paul told reporters in Louisville that he’s in favor of Republicans using “leverage” to make the federal health care law “less bad.”

Some conservatives say they won’t vote for any spending measure that provides funding for the President’s health care plan. That’s leading to speculation over a possible government shutdown at the end of September.

The Courier-Journal reports Sen. Paul said that while he would like to see the Affordable Care Act defunded, the Bowling Green Republican added "I know that we don’t control all of the government, so we fight for what we can get.”

Democrats say the controversy over the federal health care law was settled when its legality was upheld by the U.S. Supreme Court. Supporters of the Affordable Care Act have warned Republicans that they’ll face a public backlash if they try to shut down government operations in an effort to defund the program.

After months of deliberations, Kentucky Gov. Steve Beshear has decided to expand Medicaid in Kentucky under the Affordable Care Act, also known as Obamacare—a move that's won praise from Democrats and health advocacy groups.

Beshear said Thursday that expansion benefits Kentucky in many ways.

"This move makes sense not only for our health but also for our pocketbook. More important it makes sense for our future," he says.

The expansion will insure more than 308,000 Kentuckians. And according to studies done by PriceWaterhouseCoopers and the Urban Studies Institute at the University of Louisville, Medicaid expansion would bring about $800 million to Kentucky between next year and 2021.

Beshear says critics of the expansion are more worried about politics than good policy.

"They express vague and broad anxieties about costs, fears which the facts refute and they fall back on partisan national politics. If Kentucky expands Medicaid they ask, won't Kentucky be supporting Obamacare, they ask. Well to them I say, Get over it," he says.

A leading health organization in Kentucky is putting the pressure on Gov. Steve Beshear to expand Medicaid services under the Affordable Care Act.

Kentucky Voices for Health Executive Director Regan Hunt says her group is launching a two-week radio ad campaign pressure Beshear to expand Medicaid. The radio ad campaign will be partnered with a month long online ad campaign.

So far, the governor has delayed making a decision— although he seems to support the ideal, if fiscally possible.

Under the healthcare law, the federal government will pay 100 percent of expansion costs for three years and then 90 percent after that.

A new political group will hit the airwaves just after the Kentucky Derby to oppose the federal healthcare law.

The Kentucky Opportunity Coalition will run ads attacking the Affordable Care Act. They've declined to release the spot early, but have hinted that it will feature various voices calling the law a train wreck.

The KOC is run by three area women, Kristen Webb and  Bridget Bush of Louisville and Karen Sellers of Paintsville. The group is being advised by Scott Jennings, a longtime ally of U.S. Senator Mitch McConnell. Jennings is also running a separate Super PAC aimed at helping re-elect McConnell. 

Even though the Affordable Care Act has been upheld by the Supreme Court as constitutional, it still faces opposition from Republicans who hope to repeal it.

Tennessee Senate Republicans are proposing legislation that seeks to prevent expansion of the state Medicaid program under provisions of President Obama's health care law.

The measure, called "TennCare Fiscal Responsibility Act", was filed Thursday by Senator Brian Kelsey of Germantown and has 15 Senate co-sponsors. A similar version of the proposal was filed last week in the House. Last year, the U.S. Supreme Court ruled that states have the right to opt out of Medicaid expansion without losing pre-existing federal Medicaid funding.

One lesser-known aspect of the Affordable Care Act is it’s reliance on state health cooperatives —  which work separate of the state- or federally run health exchange, but are free to offer their own brand of insurance on the exchange.

But recent Congressional deal-making is putting those co-ops in danger.

While states are getting grants to fund their exchanges, co-ops were getting federal loans which had to be paid back within five years.

But the Washington Post reports that the fiscal cliff deal struck weeks ago kills off the co-op loan program for many states. But because of early planning, the Kentucky Health Cooperative isn’t in any funding danger, spokesman Jim McHanie says.

“Our funding is in place and we’re moving right ahead in fact we’re in the start-up phase of development and we plan to start offering coverage effective January 1, 2014,” he says.

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