Kentucky

2018 MIDTERM ELECTION

Time: D H M S

Mitch McConnell just had 71,000 more headaches dumped on him.

OK, I can't embed the video and even the link above just goes to the general Hardball video archive page, but on MSNBC's Hardball this evening, Kentucky Governor Steve Beshear gave an updated total for ACA enrollments via the Kynect exchange: 521,000 Kentuckians. The exact quote, about 2 minutes into the segment:

“The numbers speak for themselves...from the time we opened up our healthcare exchange on October 1 at 12:01am, Kentuckians started swarming all over that website, and today, 9 months later, 521,000 Kentuckians, almost 1 in 10 Kentuckians have signed up for affordable healthcare coverage.”

He repeated the 521K number not once more but twice; obviously this was the key talking point he wanted to emphasize. Unfortunately, as has been typical for Kentucky since the end of open enrollment, he didn't break out QHPs from Medicaid/CHIP enrollments.

The last time I updated the Kentucky numbers, all I had to go on was a rough number of around 450,000 people enrolled via Kynect, without any breakdown between private QHPs and Medicaid enrollees. At the time, I took the official 4/19 numbers and then assumed a 90/10 Medicaid/QHP split for the additions since then. This gave me an estimated breakdown of around 87K QHPs & 363K Medicaid.

Today, while there's no updated numbers provided, Joe Sonka over at LEO Weekly brings a hard breakdown of how the 4/19 Medicaid numbers break out:

A nice unofficial update from Kentucky...but again, no QHP/Medicaid breakout. As I did last time, I'm going to play it cautiously and assume 90% Medicaid & 10% QHPs; since the combined total was around 421,000 last time, this brings the totals up to around 87,000 exchange QHPs and 363,000 Medicaid enrollees;

Sebelius later tweaked Sen. Mitch McConnell of Kentucky by pointing out that Kentucky’s state health insurance program, the Kentucky Health Connector, now has 450,000 people enrolled in it and many of them had no health care before.

I debated whether I should bundle this point in with the prior Kentucky post, but decided it was worthy of a separate entry.

As I noted there, Kentucky has now enrolled around 335,000 people in Medicaid via the Kynect ACA exchange; an impressive number.

The thing is, according to the Kaiser Family Foundation, only about 350,000 Kentuckians who weren't insured prior to January qualified for Medicaid in the first place (including both woodworkers as well as ACA expansion). This means that theoretically up to 96% of all Kentuckians eligible for Medicaid have now been enrolled!

This isn't an official update; it doesn't give an exact number, and there's no QHP/Medicaid breakout, but it's better than nothing:

WASHINGTON – Kentucky Gov. Steve Beshear charged Tuesday that Senate Minority Leader Mitch McConnell and other critics of the federal health care law are being "disingenuous," attempting to be for a state program that is no different from Obamacare.

The governor called the state health care exchange known as kynect "highly successful," enrolling 421,000 Kentuckians — with 75 percent of them receiving coverage for the first time in their lives.

The final enrollment period breakdown was 82,792 QHPs and 330,615 Medicaid enrollees, or 413,407 total, so this represents an increase since 4/19 of 7,593 total.

If we were still in the open enrollment period, of course, I'd just use the same 20/80 ratio that the existing numbers suggest, but since we're in the "off season" for QHPs this is trickier. I'll assume a 10/90 ratio until I hear otherwise, which would mean that KY's QHP total is now up by 759 and Medicaid is up 6,834.

So, yesterday I posted an item about how the ACA has cut Kentucky's uninsured rate by at least 50% since last October. This is significant news, but I also posted similar items about impressive uninsured rate drops in New Jersey (38%), Minnesota (40%) and especially Massachusetts (a good 86% or so, down to nearly zilch). All four posts received various levels of retweets on Twitter. However, the Kentucky one in particular apparently caught the eye of one David Simas, aka the "Assistant to the President and Deputy Senior Advisor for Communications and Strategy."

Since today seems to be "How much has the ACA cut the uninsured rate by in this state/that state?" day, I thought I'd dust off this TPM article from way back on April 1st:

Obamacare has cut Kentucky's uninsured population by more than 40 percent, signing up roughly 360,000 residents since enrollment opened up on Oct. 1, according to the Louisville Courier-Journal.

Some 75 percent of them -- 270,000 -- were previously uninsured. That means Kentucky's uninsured population of 640,000 has come down by 42 percent.

At the time, the headline read "Obamacare Cuts Kentucky's Uninsured Rate By 40 Percent", which was impressive enough. However, that was wayyyy back over 2 months ago. A little simple math tells the rest of the story:

Rand Paul has a habit of being just as much of a weasel as his senior counterpart Mitch McConnell on most issues, but occasionally being "refreshingly" honest. Case in point:

FRANKFORT — Saying he favors a full repeal of "Obamacare" but citing a "technical question," U.S. Sen. Rand Paul on Friday gave cover to U.S. Senate Minority Leader Mitch McConnell a week after McConnell said Kynect and the federal law are not connected.

..."There's a lot of questions that are big questions that are beyond just the exchange and the Kynect and things like that," Paul said.

"It's ... how we're going to fund these things."

...When asked a second time if he would want to dismantle Kynect, Paul said: "I would repeal all of Obamacare."

Over the past 7 months, plenty of healthcare reporters, insurance executives and political pundits have started following this site and/or my Twitter feed. For the most part the ones I know of tend to be either of unknown ideology or left-leaning, but there's also a substantial number of Republican, Conservative, Libertarian or other wise right-leaning types, and that's fine.

I've butted heads publicly with a few of these folks. In some cases they've presented honest, intelligent disagreement; in others they've spewed tired, BS talking points. Here's a great opportunity to prove whether you're dealing an intellectually honest hand or not. I present you with the following:

MCCONNELL: KY. EXCHANGE UNCONNECTED TO HEALTH LAW

LOUISVILLE, Ky. (AP) -- Kentucky Sen. Mitch McConnell says he would try to repeal the Affordable Care Act if he's elected Senate majority leader.

But the veteran senator won't say what would happen to the 413,000 Kentuckians who have health insurance through the state's health care exchange.

McConnell told reporters Friday that the fate of the state exchange is unconnected to the federal health care law. Yet the exchange would not exist, if not for the law that created it.

The article claims that these numbers are "through 3/31", but that's obviously an error, since a previous update directly from Kynect made it clear that the QHP number was several thousand lower than that as of early April. Doesn't really matter, however; these are still outstanding results for Kentucky:

At a Capitol news conference Tuesday, the Democratic governor announced that 413,410 Kentuckians enrolled for health-care coverage through the online insurance marketplace called "Kynect" in its first open-enrollment period, from Oct. 1 through March 31.

...He said about 75 percent of the people signing up for health insurance in Kentucky had no previous insurance and that 330,615 people qualified for Medicaid coverage.

Beshear described it as "deeply satisfying" that 10 percent of the state's population "finally has affordable, quality health insurance that gives them assurance that if they get sick or hurt, they'll get the care and they're not in danger of bankruptcy."

...More than one out of every 10 Kentuckians has health insurance through Kynect, Haynes said.

This just in...Kentucky's tally is now up to nearly 80K exchange QHPs and 323K Medicaid enrollees:

BREAKING: 402,407 Kentuckians are enrolled in @kynectky. 322,827 in Medicaid, 79,580 have purchased private insurance. #ACA #kyga14

— Joe Sonka (@joesonka) April 10, 2014

Still ~75% of @kynect enrollees previously did not have insurance. That's over 300,000 Kentuckians who now have health coverage due to #ACA

— Joe Sonka (@joesonka) April 10, 2014

OK, this just adds to the confusion over the "extension periods"...not only is Kentucky joining the "you have until 4/15 if you started by 3/31" brigade, but it appears that they're also allowing people to start the application/enrollment process between 4/4 - 4/11 as well:

Gov. Steve Beshear announced Tuesday that the state will extend its deadline. People will be able to file for health insurance from April 4 to April 11.

The official deadline had been midnight March 31. Gwenda Bond, spokeswoman for the Cabinet for Health and Family Services, said 21,000 people signed up over the weekend, including 12,000 people who signed up Monday. The deadline affected only those signing up for private health insurance, because those eligible for Medicaid can apply at any time.

Because of the high demand, Bond said, state officials decided to add additional days for enrollment or a "special enrollment period." The days between the March 31 deadline and the special enrollment period will allow for some tweaks to the technical system to allow for the extension, she said.

Huh. Good for them, but if that's the case, why not just bump this out to 4/15 and be done with it? Weird.

OK, the kind folks at KynectKY have helpfully cleared up their final 3/31 numbers:

Kynectky Here is what I have. This is as of 7:00AM 04-01-14.Total QHP Enrollments: 77,044; Total MCO Enrollments: 294,221.

UPDATE: I've been so busy plugging these numbers into the spreadsheet that I haven't had a chance to see what the true impact is...and in Kentucky, it's nothing short of amazing:

Obamacare has cut Kentucky's uninsured population by more than 40 percent, signing up roughly 360,000 residents since enrollment opened up on Oct. 1, according to the Louisville Courier-Journal.

Some 75 percent of them -- 270,000 -- were previously uninsured. That means Kentucky's uninsured population of 640,000 has come down by 42 percent.

UPDATE: (sigh) OK, another very slight update:

Wow, a personal response from the KynectKY Facebook Page:

Kynectky Charles Gaba Total QHP Enrollments = 73,080; Total MCO Enrollments = 286,222.

I don't think this is the final 3/31 total, however, since this adds up to 359,302, which was posted as of around 4pm yesterday.

However, they've also just announced another 12K "processed through 8:30am today", so I'm not sure whether those are counted as part of the 3/31 total or not. I'm going to assume that they were entered last night and just took a few hours to actually process fully...therefore they count towards the 3/31 tally (unless they clarify otherwise), using a 20/80 ratio of 2,400 QHPs to 9,600 Medicaid:

Kentucky's last update, as of 3/27, was 70,273 exchange QHPs and 280,113 Medicaid, a total of 350,386.

Assuming the same 24/76 split that the prior update had, that should mean an additional 2,060 QHPs and 6,550 Medicaid added.

Over 359,000 have applied with #kynect as of 7AM today. Under 9 hours are left in open enrollment. Thousands have applied, so should you.

— kynectky (@kynectky) March 31, 2014

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