Under former Gov. Steve Beshear's (D) leadership, Kentucky became a national leader in health care. The Bluegrass State implemented the Affordable Care Act to perfection and saw results that most states envied. No state has seen a sharper improvement in its uninsured rate.
Kentucky voters decided last year, however, to go in a very different direction, electing a far-right amateur, Matt Bevin (R), as their new governor, inadvertently endorsing his anti-healthcare platform.
The Republican, in his first year, has already scrapped Kentucky's state-based marketplace, choosing instead to direct consumers to the federal healthcare.gov, and now he's pushing to overhaul Kentucky's Medicaid-expansion policy, uprooting an effective system while demanding conservative "reforms."
Part of the problem with the debate is that the Bevin administration seems to have a unique understanding of health care coverage. Reporter Joe Sonka flagged this fascinating report the other day from the Courier Journal in Louisville.
"There has not been a historic drop in uninsured -- this is misleading," [cabinet spokeswoman Jean West's] statement said. "Medicaid is not health insurance -- it is a benefit program like SNAP (food stamps) or TANF (Temporary Assistance for Needy Families) ... What we have seen is a historic rise in people on taxpayer-funded Medicaid."
Got that? It may look like a low-income Kentucky family has coverage, which means being able to afford a doctor's visit or a trip to the hospital, but that's because that family is covered through Medicaid.
And according to the Republican governor of Kentucky, Medicaid coverage shouldn't count as coverage at all because, well, because the Bevin administration says so.
How many officials would be willing to apply similar assessments across other government benefits? If more students graduate from public high schools and the drop-out rate improves, would Kentucky's governor say that's "misleading" because public education is a government program?
If the crime rate goes down in Kentucky, would that be dismissed as irrelevant because of public dependence on taxpayer-funded law enforcement?
How exactly does Team Bevin intend to tell struggling families, "Don't worry, we're taking your coverage away, but it didn't really count in the first place"?
As things stand, Bevin's administration has told federal officials that if the Obama administration rejects the governor's Medicaid "reforms," the Republican will reject Medicaid expansion altogether and strip over 400,000 Kentuckians of their coverage.
That may seem needlessly cruel, but according to Bevin's office, "Medicaid is not health insurance," so the crises these families would face don't really count.