Affordable Care Act

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.

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  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.

State Sen. Julie Denton has filed two bills that would put control of implementation of the Affordable Care Act into lawmakers’ hands.

Gov. Steve Beshear created a state-run health exchange through an executive order and is mulling whether to expand Medicaid. Both are parts of the ACA, also known as Obamacare.

Denton says her goal is to let lawmakers have some say in either matter.

“Well all those pieces of legislation will do is say that only by the authority of the General Assembly can we expand our Medicaid program or can we set up the health benefit exchanges,” she says.

But House Speaker Greg Stumbo says his chamber will likely ignore Denton’s bills.

And the governor says he’s not worried about them either.

As the 2013 Kentucky legislative session begins, Tea Party activists are encouraging lawmakers to abandon the implementation of the Affordable Care Act — also known as Obamacare — in the state because of fiscal and health care concerns.

About 50 activists rallied in the Capitol Rotunda Tuesday; they wanted their state legislators to hear their concerns as the 2013 legislative session began.

Kentucky can’t afford running its own health exchanges  or to expand Medicaid, argued David Adams, a rally organizer.

“It doesn’t take a forensic accountant to look at our fiscal situation and realize that we have no business getting into this sandbox whatsoever,” Adams says.

Kentucky Tea Party activists are carrying their fight against the Affordable Care Act into the new year.

Before the first gavel of the session Tuesday, Tea Party activists plan to rally in the Capitol Rotunda against the ACA.

It’s the second capital rally against the law, which Kentucky has actively worked to implement under an executive order from Governor Steve Beshear.

Rally organizer and activist David Adams says the goal of the event is to convince lawmakers to pass a measure overturning Beshear’s order.

The Speaker of the Kentucky House says it’s a no-brainer for Kentucky to expand its Medicaid program under the Affordable Care Act.

Under the health care law, states can expanded their Medicaid rolls to 138 percent of the poverty line, with the federal government picking up the tab for three years. 

Kentucky Governor Steve Beshear has yet to decide whether Kentucky will expand, saying he will calculate costs after 2017, when the feds pay only 90 percent of the expansion.

But Democratic House Speaker Greg Stumbo says he's encouraging Beshear to commit to Medicaid expansion now.

“I think it would be a penny wise and a pound foolish not to find the money,” Stumbo says.

Despite progress toward building a state-run health insurance exchange in Kentucky, Governor Steve Beshear will likely have to re-issue an executive order to keep it alive.

Beshear issued an order creating the exchange earlier this year, after the Supreme Court ruled the Affordable Care Act was constitutional. And it’s a goal of state health officials to get the exchange protected under a law, rather than an executive order.

But Republican State Senator Tom Buford says his colleagues aren’t likely to support an exchange law.

“Probably not, in my opinion, we will probably allow the Governor to re-order the executive order again," said Buford.

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