Kentucky’s House Minority Leader Jeff Hoover announced today that Kentucky should join the roughly 10 states that are choosing to opt out of the expansion of Medicaid to more individuals under the Affordable Care Act.
Under the new law, from 2014 through 2016 the federal government would pick up the tab for the additional millions gaining coverage under Medicaid, at no cost to the states. From 2017 through 2019, the federal government would pay for over 90 percent of this coverage, with the state paying 10 percent from 2020 on.
Last week’s Supreme Court ruling upheld the constitutionality of the law but ruled that states can choose to opt out of the Medicaid expansion. Hoover claims that these additional costs that Kentucky will pick up will hurt the state’s already weak budget, causing other programs and services to be cut.
But Hoover and his friends in the House GOP also cite someone else to back up their claims:
“House Republicans point to numbers from the Urban Institute that show 400,000 uninsured Kentuckians who earn less than 138 percent of the federal poverty level would be eligible for Medicaid under the expansion.”
So I guess the Urban Institute must know their stuff, if House Republicans are citing the think tank.
And what exactly does the Urban Institute say about how the ACA Medicaid expansion will bust the budget of Kentucky’s state government, obviously leading to either tax increases or cuts in education and other government services?
Not so much. Actually, the Urban Institute says Kentucky and all but four states will save money with this reform. While costs will indeed go up for all states ($547 million in Kentucky) by 2020, what Hoover neglects to mention is how much states like Kentucky will actually save by certain patients’ care moving to the fed’s responsibility on payment (mental health, long-term home care, pregnant women), and most importantly, the dramatic reduction in “uncompensated care” — essentially, reducing the amount of money that the state must pay hospitals to reimburse them for providing emergency services for the previously uninsured.
Taking a conservative estimate on Kentucky’s potential savings, the Urban Institute (KY GOP approved) expects Kentucky to save anywhere from $140 million to $828 million by 2020.
So according to the Urban Institute, the dreaded Obamacare Medicaid expansion will bring to Kentucky:
- additional coverage for around 400,000 low-income Kentuckians
- an additional $140-$828 million dollars saved in the state budget
Additionally, the number of uninsured adults earning less than 133 percent of the poverty line in Kentucky is expected to decrease by 57.1 percent under this expansion. Where does that rank among all states? No. 1.
Gov. Steve Beshear has not made up his mind yet on whether to go through with the Medicaid expansion. But if Rep. Hoover thinks that the Urban Institute is a good reference for the facts on this matter, by all means, we suggest the governor check out those numbers.