While the Trump Administration is slowly putting the wheels in motion to repeal the Affordable Care Act, one state governor has been trying for over a year to do so in his own state. Kentucky Republican governor Matt Bevin first moved to dismantle the ACA in KY last January (2016). In a letter to the HHS, Bevin advised that he planned to move Kentucky’s health exchangeKynect directly to HealthCare.gov, citing “redundancy” amongst the exchanges, despite Kentucky already having a successful state-run exchange for three years.
His words became final action this past November—as KY residents were moved to enroll via HealthCare.gov—but the transition was anything but smooth. Time, access to information, and understanding forms and plans were a few of the issues highlighted from enrollees during the enrollment process. Those who had enrolled through Kynect in 2016 were required to re-enroll through HealthCare.gov to remain insured as of January 2017. Any new enrollment must be through HealthCare.gov.
The rocky transition may have caused the number of insured KY residents through Kynect or HealthCare in January 2017 to drop from the number in March 2016. For those who hadn’t already enrolled on HealthCare.gov but had been covered in 2016 via Kynect, they have until March 1, 2017.
Notably, Kentucky’s transition to Healthcare.gov is not a complete transition. Kentucky is currently a state based marketplace but using the federal IT platform, HealthCare.gov. In other words, Kentucky remains responsible for performing all marketplace functions for the individual market and small business health options program (SHOP) except that state will rely on the HealthCare.gov IT platform to enroll.
Kentucky still reaps the benefits of the ACA, with the greatest uninsured drop (from 19% to 7% from 2013-2015), low insurance rates and a somewhat successful Medicaid expansion. Still, that can all change should the ACA be formally repealed by Congress. With Kentucky showing successful results with the Affordable Care Act, how easy will it be to reverse that progress within that state and all of the others?
