Tuesday Short Cuts

While the Republican nominee for governor says he would dismantle the state health-insurance exchange branded as Kynect, a GOP senator is talking about not only keeping it, but expanding it to other states to pay for the other big feature of federal health reform: expanded Medicaid.

Sen. Ralph Alvarado of Winchester made the suggestion at a legislative committee meeting where Kynect Director Carrie Banahan said it would be "disastrous" to move Kentuckians to the federal Obamacare exchange, as Republican gubernatorial nominee Matt Bevin has said he will do if elected.

Alvarado, a physician, said his concerns about Obamacare in Kentucky are mostly monetary because the state will have to start paying 5 percent of the Medicaid expansion costs in 2017, rising to the reform law's limit of 10 percent in 2020.

...Alvarado suggested that Kynect become a regional exchange and charge other states for its services, using the profit to pay for the expansion.

"There are states that want a good state exchange, but haven't been able to run one. And there are several that are about to expand Medicaid and are looking at the federal exchange," he said. "So my thought was, why not approach those states that are going to expand Medicaid, offer to do the same services that a federal exchange would do, and run the exchange for them for a fee?"

A record number of Colorado residents now carry health insurance.

Statewide, the uninsured rate plummeted from 14.3 percent in 2013 to 6.7 percent this year — the lowest ever, according to a report being released Tuesday. Nearly 5 million people are covered now.

The increase is attributable to a dramatic growth in Medicaid enrollment following Colorado's decision to raise income eligibility limits and allow unmarried adults to qualify, an option available to states under the federal Affordable Care Act.

Otherwise, the results in Colorado are mixed. More people are insured, but more are underinsured — spending more than 10 percent of their income on out-of-pocket medical costs. Large employers are covering more people, but smaller businesses have dropped employees. Only one of 40 children lacks coverage now, but one of eight adults aged 19 to 29 remains uninsured.

A Koch-backed political blitz is betting that Kentuckians won't let health care facts stand in the way of anti-Obama emotion.

The ad launched Monday by Americans for Prosperity could not be more misleading.

And the advocacy group, which was founded by David Koch of the Koch Industries conglomerate and helped fuel the Tea Party movement, is promising to send people to your door to further mislead you.

The only thing the ad gets right is the phone number, as it urges viewers to call Attorney General Jack Conway, the Democratic candidate for governor, to tell him how wrong "Obamacare" has been for Kentucky.

The rate of people who didn't get needed medical care as a result of its cost reached a 16-year-low in the three months that ended in March, as the Affordable Care Act continued to drive down the number of people without health insurance, according to a Centers for Disease Control and Prevention report released Tuesday.

The percentage of people who didn't get needed health care as a result of its cost fell to 4.4 percent. It was nearly 6 percent as of 2013 and has been on a steady downward curve since 2011, as the ACA's toolkit to expand health coverage has kicked in.

The CDC report also found that the rate of people without health insurance dropped below 10 percent in the first quarter, breaking a double-digit plateau that had persisted since the 1990s.

And in another marked decrease, the percentage of adults who said they were regular cigarette smokers hit a new low, at 15.2 percent, according to the CDC. That's down from 16.8 percent last year.