Gross:

Governor Matt Bevin hosted a round table discussion on healthcare and Medicaid reform this afternoon.

The discussion centered on a current proposal known as the Health Care Choices Act. Representatives from think tanks like the Heritage Foundation and the Pegasus Institute, joined Gov. Bevin and former Pennsylvania Senator Rick Santorum for the talk in Frankfort.

The proposed bill, “takes current flow of money from the Medicaid expansion and tax credits and puts it into a block grant proposal, gets that money out to the states and gives the states the flexibility to design a system that better meets the needs of that particular state,” according to Santorum.

Of course, Santorum praised Bevin’s plan to take away Kentuckians health care:

He also praised Gov. Matt Bevin — who joined him at the news conference — for leading the way on health reform through his pending plan to overhaul Medicaid in Kentucky by adding work requirements and other rules for some people now covered by the government health plan.

“We want to come and pitch an opportunity to also lead when it comes to reforming the individual market,” with options “better — much, much, much better than the Obamacare plans do,” Santorum said.

Bevin said the proposal is about “getting the maximum return for the finite amount of dollars available.”

The two offered few details of the plan that Santorum said likely couldn't take shape until at least 2021, other than it involves restructuring some Medicaid dollars as “block grants” and giving the state the power to decide how to allocate the money. It would also create “high-risk pools” for the very ill or people with chronic health conditions, they said.

Turning Medicaid, an open-ended entitlement plan for the states, into block grants has been repeatedly proposed by conservatives but never enacted by Congress.

That's because the idea is highly unpopular and was rejected during efforts to repeal the federal health law, said Dustin Pugel, with the progressive Kentucky Center for Economic Policy.

“Block granting is a form of funding strangulation that would leave us completely unable to respond to the health needs of Kentucky in the event of a downturn or outbreak,” Pugel said. “It is a horrible idea that was repeatedly rejected during the 2017 ACA repeal fight.”

High-risk pools were offered in many states, but largely ended when the Affordable Care Act became law and banned denial of coverage to people with pre-existing conditions.

High-risk pools proved very costly with some people unable to afford premiums, and some states were forced to create waiting lists for coverage because of limited funds, according to Kaiser Health News.

Health Care will be a huge issue this year. Democrats know this and one of Bevin’s potential opponents, Attorney General Andy Beshear (D. KY), is dedicated to make sure you get affordable health care:

Kentuckians can now visit ag.ky.gov/healthcare to track Attorney General Andy Beshear’s fight for better, more affordable health care.

Beshear said the website provides an opportunity for Kentuckians to learn about what is truly at stake in three legal cases that he has joined to ensure health care and pharmacy benefits are not taken away from more than 1.3 million Kentuckians

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Beshear and attorneys general from15 other states and the District of Columbia are arguing that if the case is not overturned Kentuckians and Americans will be harmed in 10 ways:

  1. Those with pre-existing medical conditions, like acne, asthma, cancer, COPD and diabetes, may no longer be able to get health insurance
  2. Expanded Medicaid would be eliminated
  3. Children under the age of 26 would not be able to remain on their parents’ insurance
  4. Seniors would have to pay more for prescription drugs
  5. Women would once again be charged more than men
  6. Guaranteed pregnancy coverage would be eliminated
  7. Substance Use Disorder Treatment would no longer be a required benefit
  8. Rural hospitals would suffer
  9. Children would lose access to no-cost immunizations and well-child visits
  10. Older Kentuckians would be charged vastly more than younger ones.

The case is currently on appeal at the U.S. Court of Appeals for the Fifth Circuit, where a briefing schedule has been set. The brief by Beshear and the coalition of attorneys general is due March 25, 2019.

In the second case, Beshear and 10 state attorneys general, along with the District of Columbia, are asking a federal court to reject the U.S. Department of Labor’s Association Health Plan (AHP) Rule that would allow individual and small group health plans to not comply with the Affordable Care Act (ACA).

Beshear is one of three major Democrats running for the chance to unseat Bevin. While Kentucky is a very red state and it will be a tough race. But Louisville political expert, Perry Bacon, makes some great points that Bevin isn’t a lock for re-election:

But I don’t think Bevin is an overwhelming favorite — and he could certainly lose. Why? First of all, while Americans usually vote along party lines at the federal level, they are more willing to vote for the other party in state races.

In the U.S. Senate, 89 of the 100 senators are from the same party that voted for their state for president. But 11 of the 50 governors are not from the party that their state backed for president. Some successful gubernatorial candidates, like Larry Hogan, the Republican in fairly blue Maryland, have been very skilled at portraying themselves as kind of non-ideological figures. Others, like Laura Kelly, a Democrat who was elected in conservative Kansas in November, ran against unpopular opponents who divided the dominant party in their states.

So here in Kentucky, you could imagine that some voters who might have backed Trump in 2016 disagree with how Bevin has handled the pensions issue or disparaged teachers. Those voters could decide either to vote for one of the Democratic candidates or not vote at all, which would also help the Democrats.

Second, off-year elections tend to have fairly low turnout. Bevin won 52 percent of the vote in his first gubernatorial run, about 511,000 total votes.

In 2016, Trump received 1.2 million votes. Hillary Clinton won 629,000, so more Kentuckians have voted for Clinton than Bevin.

If Democratic voters are extra-motivated against Bevin and Republicans are lukewarm about him, that’s a path to victory for Democrats. But it’s a complicated one — there are about 571,000 more Trump voters than Clinton voters in Kentucky, and Trump could personally come to this state in the fall to boost turnout among his base.

Third, there was a kind of blue wave in Kentucky in 2018 — and maybe it crests in 2019. Robert Kahne of Forward Kentucky calculated that Democrats won about 46 percent of the total votes in races for the state House of Representatives in 2018, up from 40 percent in 2016. (So Republicans won 60 percent of the total statehouse vote in 2016, 54 percent in 2018).

But this didn’t translate to a lot of seat gains for Democrats. Why not? Well, Democrats are losing ground in most counties in the state, but winning by bigger margins in the state’s population centers, Fayette and Jefferson counties.

Nationally, Trump and his political style seem to exacerbate the urban-rural divide, and that appears to be happening in Kentucky as well. So if Louisville and Lexington voters keep shifting left, that could lift the Democrats to victory, with anti-Trump voters turning out against Bevin in part to punish a president they hate. Ideally, for Democrats, turnout is high in the urban areas but not as much in the rural ones.

You will notice I’ve largely left out scenarios assuming that the political styles or personas of Adam Edelen (the third of the top tier Democratic candidates) Adkins or Beshear will shift large numbers of GOP voters to Democrats or inspire huge Democratic turnout. I’m not saying that won’t happen, we just don’t have a lot of data or history to use in projecting the effects of those individual candidates on the race.

Let’s make clowns like Bevin and Santorum pay for trying to take away people’s health care. Click below to donate and get involved with the Democrat you back for Governor:

Andy Beshear

Rocky Adkins

Adam Edelen

  • February 20, 2019