The University of Louisville’s Commonwealth Institute of Kentucky released a report on the Affordable Care Act (ACA)’s impact on Kentucky’s health and economy since 2014. The report documents Kentucky’s numerous health and economic gains that largely hang in the balance of the federal court case Stewart v. Azar, brought by sixteen Kentuckians against the Centers for Medicare & Medicaid Services (CMS), which re-approved Governor Bevin’s 1115 Medicaid waiver, called Kentucky HEALTH, on November 20, 2018.
As Kentucky weathers numerous threats to its health care safety net, this report offers a new baseline to measure changes in insurance coverage, access to care, health outcomes, and economic impact.
- Insurance coverage for Kentuckians increased dramatically under the ACA, largely due to the state’s decision to implement Medicaid Expansion for those living at or below 138 percent of the Federal Poverty Level. Kentucky’s uninsured rate fell from 20.4 percent in 2013 to 7.8 percent in 2016–the largest decline in the country.
- Access to care increased dramatically under the ACA due to expanded Medicaid, protections for pre-existing conditions, new individual plan offerings with more comprehensive coverage, and income-based tax credits.
- Each Medicaid dollar spent in the health care system generates a return of $1.35 to $1.80 to Kentucky’s economy.
- More than 16,000 jobs have been created in the health care and social services sectors since 2014.
- Expansion states have increased Medicaid budgets; however, benefits such as reduced uncompensated care and job growth in health and social services offset the increase.
The report found that numerous studies associate expanded coverage with improved overall health, increased access to care, higher rates of preventive care, less reliance on emergency room care, better chronic disease management, and a decrease in self-report of psychological distress and poor mental health days. More affordable access to care has also led to a decrease in health care related debt, which used to be the number one cause of personal bankruptcy.
Other states, such as Indiana and Arkansas, have implemented similar waivers with disastrous results. In Indiana, 55 percent of those subject to premium payments failed to meet the requirement, and more than 18,000 in Arkansas lost coverage for failing to meet reporting requirements in 2018. In both states, beneficiaries cited confusion and lack of awareness as reasons for their inability to comply.
InsureKY is a statewide coalition of nonprofits formed to promote more affordable health insurance, better care, and stronger consumer protections for all Kentuckians, including Homeless and Housing Coalition of Kentucky, Kentucky Center for Economic Policy, Kentucky Equal Justice Center, Kentucky Voices for Health, and Mental Health America of Kentucky.
Contact: Emily Beauregard