2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Kentucky: If Andy Beshear wins, KY could be the 7th state to break away from HC.gov

Last week I noted that Pennsylvania is joining Nevada, New Mexico, New Jersey and (apparently) Oregon in moving away from the federal ACA exchange mothership known as HealthCare.Gov:

Pennsylvania moves to take over health insurance exchange

Pennsylvania is moving to take over the online health insurance exchange that’s been operated by the federal government since 2014, saying it can cut health insurance costs for the hundreds of thousands who buy the individual Affordable Care Act policies.

...The bill is backed by Gov. Tom Wolf, a Democrat, and his administration says it would make two important changes to reduce premiums for the 400,000 people who purchase health insurance through the Healthcare.gov online marketplace.

Sure enough, the bipartisan bill passed the House committee unanimously, and has moved on from the Insurance committee to the Rules committee and now the Appropriations committee. Judging from the unanimous vote and this stunningly strong op-ed co-written by the Democratic and strong>Republican Floor Leaders of the PA House of Representatives (the title actually starts off with "YES, WE CAN!" and the accompanying photo is of the word "Obamacare" in Scrabble tiles), it sure sounds like it's a done deal.

If all of them follow through (Nevada is the only one I'm 100% certain about, though New Mexico is pretty much a lock starting next year), that will make six states which will have fully broken off from HC.gov to date, joining Idaho, which did so back in 2014. In the case of Nevada and Oregon, they both did originally operate their own full exchanges the first year of Open Enrollment, but they had such terrible technical problems that they both had to pull the plug and hop onboard the mothership. Nevada is giving their own platform another shot, and Oregon is seriously considering doing so.

However, there's one more state which could still make the move as well: Kentucky.

Kentucky, you may recall, did have their own full exchange from Day One: kynect. For years, the Bluegrass State held the unlikeliest success story of Obamacare...before GOP Governor Matt Bevin pulled the plug out of pure spite:

From the earliest days, Kentucky’s efforts to implement Obamacare have earned national acclaim. As the troubled roll out of the national health care exchange website was ruthlessly mocked by late night television, Fortune praised “one health exchange success story”: Kentucky’s new state-level marketplace.

Unlike most southern states, Kentucky opted to both set up its own state exchange (the Kentucky Health Benefit Exchange, commonly known as “Kynect”) and to expand Medicaid under the Affordable Care Act. These efforts, ordered by Gov. Steve Beshear (D) and overseen by Governing magazine’s 2014 Public Official of the Year Carrie Banahan, helped get 521,000 Kentuckians insurance coverage in the first year alone. According to a Gallup poll, by the first half of 2015, Kentucky’s uninsured rate had fallen from 20.4 percent in 2013 to just 9 percent, the second largest drop of any state. Governing feted Kentucky as “one of the few states that got everything right.”

In testimonials provided to ThinkProgress by Kentucky Voices for Health, a coalition of health advocacy groups, many Kentuckians agreed. “Thank God for Kynect,” said Eddie Alvis, who after years of struggling financially was able to get health insurance, and discovered he had severe asthma. ...And Helen Spalding, who lost her job and benefits after a serious car accident, was also able to purchase insurance. “Kynect has been here for me,” she said. “It’s a blessing.”

But with Beshear term-limited, Bevin, the GOP nominee, has made it clear he wants to reverse course. The Tea Party-backed candidate vows he’ll do away with both the successful state exchange and the Medicaid expansion that has helped hundreds of thousands get affordable health care — moves that the governor could likely make unilaterally.

Unfortunately, Matt Bevin did win, and he did indeed dismantle Kynect. The Kentucky Health Benefit Exchange itself is still in operation, but that's not the same thing at all. Kentucky's status is now the same as that of Oregon, Nevada and New Mexico...they officially have their own exchange board and legal status, but not their own platform, which allows for far more control over their destiny, among other things.

Ironically, Bevin didn't end up killing off ACA Medicaid expansion...at least, not yet...although he's doing the best he can to cause major damage and pain to it via draconian work requirements which keep getting shot down by the courts.

If, however, Bevin is beaten in his reelection campaign this November, Kynect could very well be brought back to life. Aside from being Kentucky's Attorney General, his opponent also happens to be...Andy Beshear, otherwise known as former Governor Steve Beshear's son.

And sure enough, when you visit Beshear's campaign website and check out his healthcare policy explainer, it includes this:

Six years ago, Kentucky said we’re taking charge of healthcare reform and that’s what we did, creating the Kynect program, one of the most successful in the country. Matt Bevin thought that the federal government could do a better job and dismantled Kynect. That was dead wrong, and as governor, I will fix it.

...When previous administrations chose to develop Kentucky’s own health system rather than use the new federal health care system, they did so because they believed Kentuckians knew what was best for Kentucky. But Matt Bevin eliminated Kynect, despite widespread recognition of Kynect’s success, and now threatens to limit or even eliminate expanded Medicaid. We need to build on the progress we have made covering so many Kentucky families, not end it for petty political reasons.

It sure sounds like he's committed to at least trying to pull his father's creation out of the scrap heap and bringing it back to life if given the chance. I'm keeping my fingers crossed.