Senate bills would require legislative approval for Medicaid expansion, health benefit exchange

bmusgrave@herald-leader.comFebruary 20, 2013 

FRANKFORT — Gov. Steve Beshear would need the legislature's permission to expand Medicaid or implement key parts of the federal Patient Protection and Affordable Care Act under two bills approved Wednesday by a legislative panel.

Senate Bill 39 would require legislative approval to expand Medicaid, the state-federal health-care program for the poor and disabled. Senate Bill 40 would require Beshear to get the General Assembly's approval before starting a state-run health-benefit exchange, an online insurance marketplace for people to buy insurance. The exchange is a key part of President Barack Obama's Affordable Care Act.

The vote on the bills split along party lines. Seven Republicans voted for the proposals and three Democrats opposed them. There was no debate on either bill.

Beshear, a Democrat, created the health-benefit exchange this summer by executive order. It is scheduled to go live on Jan. 1, 2014.

Republicans have repeatedly tried to block the health-benefit exchange, raising questions about the cost of implementing it. The Beshear administration has used federal grants to pay for start-up costs. Administration officials have said an existing tax on insurance companies will be used to pay for operating costs.

Expanding Medicaid eligibility — also part of Obama's health-care legislation — to an additional 400,000 Kentuckians is expected to happen in 2014. The federal government will pay all of the additional costs in the first three years and 90 percent of the cost in the fourth year.

"This is going to be an expensive endeavor," Sen. Julie Denton, R-Louisville, said, explaining why she sponsored both bills. "We need to have input."

"This is in no way a slight to the governor," Denton said.

Both bills now go to the full Senate for consideration.

Beth Musgrave: (502) 875-3793. Twitter: @BGPolitics. Blog: Bluegrasspolitics.bloginky.com.

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