Kynect was not sustainable, Kentucky officials say

“The day of reckoning has come, and we’re going to have to pay the bills,” Health and Family Services Secretary Vickie Yates Brown Glisson told the House budget subcommittee for human services.

An hour earlier, at a news conference down the hall, several Kentucky farmers described Kynect as a lifeline that provided their families with affordable health insurance. The farmers said they fear what will happen after Bevin dismantles Kynect, shifts the state to the federal health insurance exchange and toughens Medicaid eligibility rules.

“Family farmers and other small businesses are the foundation of Kentucky’s economy. But I’m afraid our needs are being drowned out by political clamor and the ideological divide over the Affordable Care Act,” said Oldham County farmer Ben Abell at an event organized by several pro-Kynect health groups.

So the debate continues, with state officials planning to end Kynect on one side and at least some of the people who use Kynect on the other.

Glisson and Medicaid Commissioner Stephen Miller gave the House panel an overview of Bevin’s proposed budget for the Health and Family Services Cabinet.

The biggest expense will be Medicaid, which provides health coverage for the poor and disabled. As a result of Beshear’s decision to expand Medicaid to people who earn up to 138 percent of the federal poverty level, there are now 1.3 million Kentuckians enrolled in the program, including 400,000 children, Miller said.

Of the $21.6 billion projected to be spent on Medicaid in Kentucky over the next two years, the state will pay $3.7 billion, with the federal government covering most of the rest.

Bevin is asking the federal government for a waiver that would let him restructure the state’s Medicaid program, charging co-pays to recipients to help offset the costs, or, if that is unsuccessful, reducing the scope of eligibility to trim the rolls.

Bevin also wants to close Kynect and switch Kentuckians to the federal HealthCare.gov exchange for the next enrollment period this fall. This should not result in anyone losing their health coverage, Glisson said.

Kynect “is really just a website,” Glisson said. “It’s a website, or a portal.”

But House Democrats on the committee said Kynect is more than just a website. It came with an advertising campaign to promote it, discontinued in December, and it employs more than 500 navigators, called Kynectors, who went into communities and walked people through the application process.

Glisson said she did not know how many Kynectors, if any, will remain after Kynect ends. On Feb. 29, the state will launch a new website, Benefind, to allow Kentuckians to apply for state benefits, including Medicaid. But the website will not be advertised to inform the public of its existence, Glisson said.

Rep. Jim Wayne, D-Louisville, protested the Bevin administration “throwing up barriers” to people looking for health coverage. Kynectors, the well-publicized Kynect website, expanded Medicaid — all of these made it easier for people to get health coverage, Wayne said.

According to the U.S. Census Bureau, after Kynect began in 2014, Kentucky’s uninsured rate dropped from 14.3 percent to 8.5 percent — the nation’s steepest decline.

“I guess I’m seeing a number of barriers being put up, either consciously or unconsciously, by planners in your cabinet,” Wayne said. “This is not a pull-yourself-up-by-the-bootstraps commonwealth. This is a commonwealth where people help each other. And it seems to me that what we have here works.”

The Bevin officials disputed that Kynect and expanded Medicaid were working as promised. Consulting firm Deloitte issued a report last year for then-Gov. Steve Beshear predicting that Kynect ultimately would pay for itself, in part through the creation of health care jobs. But the U.S. Bureau of Labor Statistics reports a decline in such jobs in Kentucky, not an increase, the Bevin officials said.

At the pro-Kynect news conference, farmers said Kynectors in their counties helped them enroll in private insurance plans or Medicaid, depending on their financial circumstances at the time. They said getting access to affordable insurance let them quit day jobs that had provided health benefits so they could focus full-time on their fields.

“Farming is a high-risk lifestyle, and I am personally not a risk-taker,” said Rae Strobel, a Meade County farmer. “I need a safety net. I can take some leaps of faith on a lot of things, but health insurance is not one of them. I know that things can happen, and we don’t want to be the generation that loses the farm.”