Beshear says Kentucky hospitals pushing for Medicaid expansion

bmusgrave@herald-leader.comApril 15, 2013 

Gov. Steve Beshear

FRANKFORT — Gov. Steve Beshear said Monday that he will decide by July 1 whether to expand Medicaid, the federal-state health care program for the poor, elderly and disabled.

During a Capitol news conference Monday on an unrelated topic, Beshear said his administration is looking at several factors, including cost, before deciding whether to expand the program that serves about 830,000 people in Kentucky.

It is estimated that more than 400,000 people in Kentucky could be eligible for the program if it expands to include people at 133 percent of the poverty level. For a single person, 133 percent of the poverty level is $15,000.

Beshear said he is getting a lot of pressure from the medical field — particularly hospitals — to approve the expansion. Many Republicans have opposed expansion, saying the state can't afford it.

The Republican-led state Senate passed a bill during this year's legislative session that would have required the two-term Democratic governor to get legislative approval before expanding Medicaid, but the measure died in the Democratic-led House.

"We have a very large uninsured population and we have a very unhealthy population," Beshear said. "Anything that we can do — that we can afford — to make our population more healthy, I'm certainly in favor of doing."

The expansion of Medicaid is a key part of the 2010 Patient Protection and Affordable Care Act. A 2012 U.S. Supreme Court decision ruled that Medicaid expansion is not mandatory and left the decision up to the states. As of March 30, 16 states have indicated they will expand their Medicaid rolls while 10 states have decided to opt out of the expansion.

Expanded eligibility for Medicaid would begin on Jan. 1. For the first three years, the federal government would pay the full cost of the newly-eligible recipients. After that, states would be required to pick up a portion of the cost. The state's portion would not top more than 10 percent through 2020.

Kentucky's Medicaid program costs about $6 billion in federal and state money. The federal government pays for roughly 70 percent of the program and the state pays for about 30 percent.

Beshear said his administration has not yet determined how much it would cost the state to add additional people to its Medicaid rolls.

"We are looking long-term as well as short-term from a financial stand point to see if it makes sense for us," Beshear said of the possible financial outlay.

Hospitals will lose some of the money they receive through Medicaid on Jan. 1 as part of the federal health care legislation.

"I think they look at the expansion as a means to at least replace some of that (money) that they are going to lose," Beshear said.

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

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