Daily Independent (Ashland, KY)

February 26, 2013

Rejecting deal

Legislators close to kicking a gift horse in the mouth

The Independent

ASHLAND — The Republican-controlled state Senate is on the verge of kicking that proverbial gift horse in the mouth and denying Medicare coverage to an estimated 181,000 low-income Kentuckians.

But Senate President Robert Stivers, R-Manchester, said the two bills the Senate approved Friday have little or nothing to do with the expansion of Medicare. Instead, their only intent is to maintain legislative oversight over what he called “a huge policy decision.”

Nevertheless, Sen. Walter “Doc” Blevins, D-Morehead, is right when he called the two bills a vote “against children and people who need this service.”

The Affordable Health Care Act — a.k.a “Obamacare” — makes an offer that Kentucky would be foolish to refuse. The law expands Medicare to include those who earn up to 150 percent of the federal poverty level and can’t afford private insurance or do not have it available through their employers. With Medicare gushing red ink in Kentucky, it may sound foolish and fiscally irresponsible to expand the program, but under Obamacare, the federal government would pay 100 percent of the cost of the Medicare expansion for the first three years and 90 percent after that.

However, in its landmark ruling upholding the Affordable Health Care Act, the U.S. Supreme Court gave individual states the right to opt out of some of its provisions. That’s what Kentucky is on the verge of doing, thanks to the political shenanigans of Republicans who control the Senate and want to do everything they can to demonstrate their opposition to Obamacare, even if it means denying health care to thousands of low-income Kentuckians, including scores of children.

The two bills that were approved by the Senate Friday along party-line votes were sponsored by Sen. Julie Denton, R-Louisville. One would require legislative approval before Beshear can expand Medicaid to cover working poor families who can’t afford private insurance.

Beshear has used his executive powers to sign Kentucky up for the Medicare expansion, contending he can do so because the expansion does not involve the expenditure of state funds for another three years. 

Senate President Robert Stivers, R-Manchester, said the bills have nothing to do with the general Republican opposition to the health care law but rather intended to maintain legislative oversight over what he called “a huge policy decision.”

The other bill would require legislative approval to establish a state operated health benefit exchange, essentially an online market where individuals and companies could shop for the most affordable private health insurance. That, too, is a component of Obamacare.

If a state declines to operate its own exchange, the federal government will do it. Beshear has already begun setting up the exchange in Kentucky, using federal grants to pay for it. He has said existing insurance taxes will provide operational funding after the exchange is up and going.

In an ideal world, the governor should get legislative approval before expanding Medicare or setting up the health benefit exchange in Kentucky. But with government so divided in Frankfort along party lines, this is not an ideal time. The Senate has given no indication that it is willing to do anything to implement Obamacare in Kentucky. But the re-election of Obama guaranteed that the law is here to stay, and Kentucky would be foolish to not take advantage of its provisions that clearly benefit the state and its residents.

One of those provisions is the expansion of Medicare. In a poll conducted for the American Cancer Society’s Cancer Action Network, 63 percent of Kentuckians said the state should agree to expand Medicare under the Affordable Health Care Act. Only 23 percent opposed the expansion.

Neither of the Senate bills have any chance of being approved by the Democratic-controlled House. By the same token House-approved bills on this subject will not be approved by the Senate.

Unless common sense and good government prevails over partisan politics, the 2013 General Assembly will end without legislative approval of the Medicaid expansion. That would mean that more than 180,000 Kentuckians who can least afford to pay for health care will be denied Medicaid coverage that would have cost the state nothing for at least three years. If that happens, shame on legislators.