Only 6 percent of Kentuckians lacked health insurance in 2015, a drop of 8.3 percentage points since 2013, according to fresh data from the U.S. Census Bureau.
The net gain of 355,000 insured people put Kentucky ahead of most other states.
The Census Bureau, which released nationwide survey data on insurance coverage Tuesday, said the largest increases in insurance coverage are in the 32 states, including Kentucky, that expanded Medicaid to the working poor under the federal Affordable Care Act, also known as Obamacare.
“We do see that expansion states have lower uninsured numbers than non-expansion states. And the decline in those without insurance over the last two years is steeper in expansion states than non-expansion states,” said Jennifer Cheeseman Day, an assistant division chief for the Census Bureau, briefing reporters by telephone.
The 2015 rate for those without insurance in expansion states ranged from 2.8 percent in Massachusetts to 12.3 percent in Nevada. For states that kept their Medicaid programs focused exclusively on those under the poverty line, it ranged from 5.7 percent in Wisconsin to 17.1 percent in Texas. The national average was 9.4 percent.
Former Gov. Steve Beshear, a Democrat, decided in 2013 to expand Medicaid in Kentucky and establish a state-run health insurance exchange called Kynect.
Although national health care advocates praised Kentucky’s insurance outreach, Beshear was replaced last year by a Republican, Matt Bevin, who successfully campaigned on a platform of repealing much of it. Bevin scrapped Kynect, referring Kentuckians to the federally run exchange. He also says Kentucky cannot afford the price of expanded Medicaid, which he puts at $1.2 billion for the state over the next five years.
Bevin spokeswoman Amanda Stamper called the new survey data “misleading without further context.”
Most of Kentucky’s coverage gains came through publicly funded Medicaid, not private insurance plans, Stamper said. Nearly one-third of the state’s population is now enrolled in Medicaid, she said.
“This is a sad commentary on the economic state of Kentucky and is not sustainable,” Stamper said. “While some are focused solely on enrollment, Gov. Bevin is focused on driving better health and employment outcomes and the long-term fiscal sustainability of the Medicaid program.”
Bevin has submitted a waiver plan to the federal government that would — if approved — allow the state to set new costs and restrictions for Medicaid recipients, such as charging co-pays and premiums and eliminating dental and vision care as part of standard coverage.
Kentucky’s remarkable progress with insurance could be undone if Bevin is allowed to reshape Medicaid or drop the expansion entirely, as he has threatened to do if his waiver is not approved, said Jason Bailey, executive director of the Kentucky Center for Economic Policy in Berea.
“The governor’s own numbers in his waiver proposal show 88,000 fewer adults covered by Medicaid within five years. That’s where the savings are supposed to come from,” Bailey said. “If the waiver went into effect as it’s currently written, we would see a rollback in the progress we’ve made in recent years.”
“There has been some talk about how a lot of these people are going to find really good jobs with benefits all of a sudden. But that’s not a reality-based observation,” Bailey said.
During the last two years, low-income adults in Kentucky sought out more primary and preventative medical care, made fewer emergency room visits at hospitals and reported improved personal health compared to their counterparts in Texas, which did not expand Medicaid, according to a study published last month in the Journal of the American Medical Association.
The study, led by researchers at the Harvard School of Public Health, studied thousands of adults from late 2013 until late 2015.
“Health insurance matters to people’s health,” lead author Benjamin Sommers said in a statement. “Our study shows that with health insurance, whether it’s Medicaid or private coverage, people can better afford their medical care, get more preventive care and chronic disease management, and ultimately achieve better overall health.”
States with the smallest uninsured populations in 2015
1. Massachusetts: 2.8%
2. Vermont: 3.8%
3. Hawaii: 4%
4. Minnesota: 4.5%
5. Iowa: 5%
6. Wisconsin and Rhode Island (tie): 5.7%
7. Delaware and Connecticut (tie): 5.9%
8. West Virginia and Kentucky (tie): 6%
9. Michigan: 6.1%
10. New Hampshire: 6.3%
National average: 9.4%
Source: U.S. Census Bureau