Kentucky Given Action Steps for Ending ACA Exchange

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By Bebe Raupe

Feb. 11 — Kentucky’s health-care exchange cannot be dismantled without relinquishing $57.5 million in grant money and devising a plan to transition participants to the federal exchange, the Centers for Medicare & Medicaid Services has informed the state.

While the current governor is intent on shelving the Kynect exchange and rolling back other Affordable Care Act inroads, Kentucky’s preceding governor launched a public campaign Feb. 11 to save them.

Former Gov. Steve Beshear (D) told reporters that voters need to be educated about what is happening to health care in Kentucky, where the ACA created “real health gains that are worth fighting for.”

Soon after taking office in December, Gov. Matt Bevin (R) notified the Department of Health and Human Services that he wants to “wind down and cease operation” of Kynect and transition participants to the federal exchange .

Ceasing Kynect operations “will create a number of challenges” that must be addressed to ensure Kentuckians have easy access to coverage for which they are eligible, whether it’s Medicaid, the Children’s Health Insurance Program or a marketplace qualified health plan, acting CMS Administrator Andrew Slavitt told Bevin in a letter made public Feb. 9.

Action Steps

Slavitt said in the letter that Kentucky must be prepared to forgo $57.5 million in federal funds awarded to create Kynect.

These funds, which have not been released to the state, cannot be used for ongoing operations or to shut down Kynect, he said, as stipulated in Section 1311 of the ACA.

Since Kentucky has successfully integrated eligibility and enrollment within the Kynect system for Medicaid and CHIP recipients, it needs to undertake state-specific transition activities, Slavitt said, including decoupling and dismantling marketplace eligibility and enrollment functionality for these programs.

Slavitt laid out action steps Kentucky needs to take immediately if it intends to transition for the 2017 plan year.

The list includes:

  •  establishing a detailed plan for how the state will meet its obligations as a state-based marketplace for the 2016 plan year;
  •  facilitating discussions between the CMS and insurance providers participating in Kynect; and
  •  developing a separate plan detailing how Kentucky will meet ongoing requirements for 2014-2016 marketplace consumers that includes giving those Kynect state consumers the ability to reapply for insurance on the federal exchange for 2017.
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    The letter, dated Jan. 28, is the federal government's first official response to Bevin's notice about shelving Kynect.

    The governor’s spokeswoman, Jessica Ditto, told Bloomberg BNA Feb. 11 that the administration is working with the CMS and expects to meet the specifications the agency has outlined for dismantling Kynect and providing consumers with other means of obtaining coverage.

    Save Kentucky Healthcare Campaign

    Bevin, who is only the second Republican governor elected in Kentucky since 1971, ran on a campaign of eradicating “Obamacare” in Kentucky, starting with eliminating Kynect. He has said it is “redundant’ and unsustainable.

    During the current enrollment period, about 85,000 people have purchased health plans through Kynect, according to state officials. Medicaid expansion through the exchange has extended health-care coverage to more than 425,000 other Kentuckians.

    Kentucky’s state-run exchange has been praised as the most successful in the nation and more citizens have health coverage today than before the ACA, former governor Beshear said, yet because of partisan politics Bevin wants to do away with it all.

    Beshear’s campaign—Save Kentucky Healthcare—is mounting an online petition to show Bevin how many people support ACA efforts in the state. By mid-afternoon on its first day, 3,430 people had signed the petition.

    In addition, the campaign will work to raise awareness of what good has been done over the past three years, Beshear said, at no cost to the state. All Kentuckians deserve access to affordable health care regardless of who’s governor, Beshear said, adding that the campaign is not about battling Bevin, but rather “protecting the people of the Commonwealth.”

    Bevin responded in a Feb. 11 statement by saying he is “focused on fixing Kentucky's fiscal crisis after eight years of the Beshear administration's increasing runaway Medicaid costs and refusing to fund the pensions of teachers and state workers to the tune of over $30 billion in unfunded liabilities.”

    To contact the reporter on this story: Bebe Raupe in Cincinnati at braupe@bna.com

    To contact the editor responsible for this story: Janey Cohen at jcohen@bna.com