Kentucky: Work requirements about to die with a whimper as Beshear beats Bevin

In 2015, Republican Matt Bevin campaigned for governor on two major healthcare-related platforms:

  • Eliminate the state's perfectly-functioning, award-winning, highly-praised and beloved ACA exchange, "kynect" for no particular reason other than spite.
  • Eliminate the state's ACA Medicaid expansion program, which as of this writing provides around 480,000 low-income Kentuckians with healthcare coverage.

For some inexplicable reason, voters in Kentucky elected him regardless. Once he got into office, he did indeed make good on the first promise, shutting down the state's perfectly good ACA exchange platform and shifting KY to the federal exchange at HealthCare.Gov.

When it came to eliminating Medicaid expansion, on the other hand, he found it to be a little bit tougher than expected; actually pulling the plug on nearly half a million people's healthcare coverage proved to be a tougher nut to crack than he thought.

Once Donald Trump became President, however, he found what he figured would be the perfect way of hurting as many people as he could without actually shutting down the program: Impose draconian work requirements on expansion enrollees!

Thankfully, portions of the U.S. federal judiciary are still working properly (for now), however, and several lawsuits and judicial rulings later, work requirements in Kentucky, Arkansas and several other states have been on extremely shaky ground. Their status hasn't been helped by the fact that over 18,000 Arkansas residents lost coverage in just a few months last year...many of whom were trying to comply with the absurd reporting requirements to maintain coverage but who simply weren't able to do so (by design).

The final blow, at least in Kentucky, appears to have come this evening, as Democratic Attorney General Andy Beshear (son of former Governor Steve Beshear, who created kynect in the first place and expanded Medicaid back in 2014) defeated Matt Bevin for the Governorship of Kentucky.

And what did Beshear have to say just moments ago in his victory speech?

Beshear says he will rescind the Medicaid waiver, says there will be a new Board of Ed, and he'll restore the voting rights for more than 140k citizens. Adds "health care is a basic human right; a pension is a promise." The crowd ROARS. I am ROARING in my living room. #KYGov

— HawaiiDelilah™ (@HawaiiDelilah) November 6, 2019

The "waiver" referred to here is the work requirement waiver which, again, was looking shaky legally anyway.

As for the kynect ACA exchange, as I noted a couple of weeks ago:

Well, it's 4 years later, Matt Bevin is pretty unpopular in Kentucky, and his Democratic opponent just happens to be Steve Beshear's son, Attorney General Andy Beshear. Seeing how kynect was one of the proudest accomplishments of his father's tenure, and given that it would be less expensive to operate kynect than to keep outsourcing their ACA exchange hosting to HC.gov, it only made sense for me to assume that Beshear would likely re-establish the state exchange if elected Governor a couple of weeks from now.

I didn't have any evidence of this until now...it was pure conjecture on my part. Today, however, I visited Beshear's campaign website and found this (it was apparently uploaded back in March):

Guaranteeing Coverage for People with Pre-Existing Conditions

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 we lead from Kentucky, we succeed. In the first year, expanding health care access injected about $2 billion into our economy and almost half a million Kentuckians got access to the care they needed through the expansion of Medicaid.6 In addition, before the reform, even more Kentuckians –almost 2 million—lived in fear of losing the health insurance they did have. That’s because insurance companies could deny coverage to anyone with a pre-existing condition—anything from asthma to hemophilia to pregnancy

He doesn't state flat-out that he'll relaunch the kynect exchange, but that sure as hell sounds like what he has in mind.


(h/t to Andrew Sprung for the inspiration)