When the Affordable Care Act was taking shape several years ago, one of its more popular provisions was the creation of state-based exchange marketplaces. By now, most Americans are probably familiar with the concept: states would create marketplaces for insurers to compete for the public's business, and consumers could choose the best plan for their needs.
Kentucky, previously a national leader in ACA implementation, embraced the idea with great enthusiasm, creating the Kynect system, which proved to be a great success. Newly elected Gov. Matt Bevin (R), however, is dismantling it anyway. The Louisville Courier-Journal reported
yesterday (via Charles Gaba
Following through on a campaign pledge, Gov. Matt Bevin has notified federal authorities he plans to dismantle kynect, Kentucky's health insurance exchange created under the Affordable Care Act. [...] Advocates had urged Bevin to keep kynect, a website praised for its accessibility and ease of use. They said helped hundreds of thousands of Kentuckians sign up for health coverage. It also included a public information campaign and workers to help people get health coverage.
"That's really disappointing," Emily Beauregard, executive director of Kentucky Voices for Health, a coalition of advocacy groups, told the newspaper. "It's a lot more than just a website."
Beauregard wasn't alone -- public-health advocates, hospital administrators, and medical professionals statewide condemned the decision, and for good reason. It's one thing to abandon a state-based model for the federal healthcare.gov because the state system wasn't working; it's something else to scrap an effective and valuable resource, just out of knee-jerk, partisan spite over "Obamacare."
But there's also an under-appreciated irony to this: Bevin, the far-right Republican governor, is also abandoning the tenets of his own ideology. By scrapping Kynect, the Tea Party Kentuckian is shifting power from his state to Washington, D.C., on purpose, without explanation.
A few states away, in Louisiana, we see a state government pointed in a more constructive direction.
Gov. John Bel Edwards (D) was sworn in yesterday's as the Pelican State's new chief executive, and he quickly turned his attention to Medicaid expansion through the ACA. Reuters reported
Edwards, the first Democrat to hold the office of governor in Louisiana since 2008, said he planned to begin accepting federal funding on Tuesday to expand healthcare to residents through the Affordable Care Act, also known as Obamacare. "Your tax dollars should not be going to one of the 30 other states that have expanded Medicaid when we are one of the states that expansion will help the most," Edwards, 49, said during the address.
About an hour after being sworn in, the new Democratic governor published
a tweet about his priorities: "Tomorrow I am going to accept the federal funding to expand Medicaid so working families in [Louisiana] can access healthcare."
It's a classic elections-have-consequences moment.