Republican state senator files bill to block Medicaid expansion, insurance exchange in Kentucky

bmusgrave@herald-leader.comJanuary 9, 2013 

FRANKFORT — Senate Health and Welfare Chair Julie Denton, R-Louisville, filed two bills Wednesday to block Gov. Steve Beshear from expanding Medicaid coverage and setting up a health-insurance exchange without legislative approval.

The expansion of Medicaid and the exchange, which would provide online information about buying insurance from private companies, are key parts of the federal Affordable Care Act, also known as Obamacare.

The health package has come under sharp criticism from many Republicans.

Denton's Senate Bill 39 deals with the expansion of Medicaid, a federal-state health care program for the poor and disabled, and SB 40 deals with a state-based health benefit exchange.

Denton said in a floor speech that the moves are too costly for the state and should not be left up to one person to implement.

Beshear, a Democrat, already has set up a health insurance exchange but has not said whether he will expand Medicaid.

He said Wednesday that he would like to do that if money is available.

He also said his administration is "moving forward" in setting up the exchange. He said he believes most Kentuckians would prefer that the state of Kentucky, and not Washington, implement its exchange.

If Medicaid were expanded in the state, hundreds of thousands more people would be covered. The federal government would pay all the extra cost in 2014 through 2016. But the federal funding would decrease to 90 percent by 2020.

The U.S. Supreme Court upheld Obamacare last year but said states could decide whether to expand Medicaid.

House Democrats said Wednesday that any attempt to stop key components of President Barack Obama's landmark legislation to expand health-care coverage to more Kentuckians will meet resistance in the House.

House Health and Welfare Chairman Tom Burch, D-Louisville, said Denton "shouldn't waste any ink" on trying to stop the health benefit exchanges or the expansion of Medicaid. Since Beshear signed the executive order creating the exchange in July, Republicans in the House and Senate have tried to block it and it hasn't worked, Burch said.

"It's not going to go anywhere," Burch said of Denton's attempts to stop the health benefit exchange. But because Beshear created the health benefit exchanges via executive order this summer, the legislature will have to approve it. It's unlikely that the Republican-controlled Senate will approve a bill setting up the exchanges.

But Beshear can sign an executive order again this summer to keep the exchange operating, Burch said.

As part of the Affordable Care Act, Medicaid will be expanded to those under the age of 65 who are at 133 percent of the poverty level. The federal government will pick up the costs to add an estimated 300,000 people to the state's Medicaid rolls from 2014 to 2017. The state will have to pick up a small portion of the costs after 2017, picking up 10 percent in 2020.

Denton said that the state is struggling to pay for the costs of Medicaid now.

Senate President Robert Stivers, R-Manchester, said leadership most likely will assign Denton's bills to her committee, "since she has the requisite expertise."

He said her legislation was "an appropriate subject matter to bring up."

Beth Musgrave: (502) 875-3793. Jack Brammer: (502) 227-1198. Twitter: @BGPolitics. Blog: bluegrasspolitics.bloginky.com

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