Dearly beloved, we are gathered here today to mark the passing of Kynect.ky.gov, Kentucky’s health insurance exchange. Gov. Matt Bevin killed it, not because it wasn’t working, but because it was working too well.
Former Gov. Steve Beshear created Kynect three years ago to help Kentuckians buy individual health insurance policies from companies under the Affordable Care Act or, if their incomes were low, enroll in Medicaid, which he expanded under the law.
Kynect has been widely praised for making Kentucky a national leader in closing the insurance gap. More than 355,000 Kentuckians who didn’t have insurance before reform do now. Kentucky’s uninsured rate has fallen from 20.4 percent to 6 percent.
Beshear, a Democrat, embraced the Republican idea that a state-managed program could work better than a federally managed one. But Bevin, a Republican, says Kynect is a costly duplication of the federal exchange, Healthcare.gov. So, beginning Tuesday, that is where 85,000 Kentuckians must go to get insurance.
Health care advocacy groups wanted to keep Kynect because of its efficiency. They say the federal website can require multiple visits and long waits while applications are processed. And if applicants are eligible for Medicaid, they are sent back to a state website, Benefind.ky.gov.
Bevin also is seeking federal permission to reshape Medicaid, which provides insurance to 1.32 million Kentuckians. His goal is to make it harder for people to get coverage, thus saving state government money.
Saving money is good. But “savings” that result in fewer people having health care just shift costs elsewhere and make the overall cost higher. It means more expensive emergency room visits and unreimbursed treatment, which providers will find a way to pass on to the rest of us. And then there is the suffering and loss of productivity by sick people and their families.
Health care is not just a personal issue; it is a community issue. Healthy societies are more productive — more economically successful and more humane. Kentucky has long been one of the nation’s least healthy states, which explains a lot.
Republicans’ opposition to the Affordable Care Act, which they like to call Obamacare, has been relentless. The House of Representatives has wasted a lot of time and money taking more than 60 pointless votes to repeal the law.
Republicans claim they want to “repeal and replace” Obamacare with something better. But they haven’t come up with anything that anyone else thinks would work. Mostly, they just spout “free market” ideology. Do we really want to go back to a system where companies can deny insurance to anyone with a health problem?
The Affordable Care Act has problems, as we have seen lately with insurance companies pulling out of markets and raising premiums by double digits. But insurance companies were doing those things before Obamacare; that’s why reform was needed.
The problems with our health care system are much deeper than Obamacare. Fewer employers are offering insurance to workers, and the value of those policies continues to decline as the costs increase. The way we pay for health care is so opaque that almost nobody understands it. Drug companies freely gouge the public.
What Republicans refuse to admit is that the way to fix health care is more government, not less. The profit-driven insurance industrial complex that now controls the practice of medicine is what got us into this mess. The United States spends 17 percent of its gross domestic product on health care — far more than any other industrialized democracy — yet we have poorer health and shorter life spans than most of them do.
Republicans like to fearmonger about “socialized medicine,” but one great example of it is Medicare for the elderly. Republicans opposed its creation and keep trying to privatize it to enrich their corporate sponsors. But Medicare has worked well for 50 years, and I doubt many recipients would trade it for some unpredictable “free market” solution.
Obamacare was designed to have had a “public option” to allow people to choose government insurance over a private policy, but insurance industry lobbyists got that killed. I can’t help but think the ultimate solution to health care reform is allowing everyone access to Medicare if they wish. A Kaiser Family Foundation poll last December found that 58 percent Americans would favor that.
In the meantime, farewell Kynect. We hardly knew you. A few months from now, we will see how many consumers think Bevin was right to kill you. We just hope that, like Obamacare, you were another step toward fixing America’s crazy health care finance system.