The chairwoman of the Senate Health and Welfare Committee has filed bills that would require legislative approval to implement key parts of federal health care reform in Kentucky.
Sen. Julie Denton, a Louisville Republican, said the General Assembly should have a say in whether the state establishes a health insurance exchange and offers Medicaid to more Kentuckians under the Affordable Care Act.
Her bills, Senate Bill 39 and Senate Bill 40, would put both issues before lawmakers for action.
Gov. Steve Beshear already has moved to establish the exchange by January 2014, but he has not decided whether to expand Medicaid coverage.
Denton, however, contended Beshear should not have sole authority in those decisions. In a speech on the Senate floor Wednesday, she cited unknown future costs as a concern.
Hundreds of thousands of low-income Kentuckians would be added to Medicaid rolls with expansion, which would lower the eligibility threshold to 133 percent of the federal poverty level.
The federal government would fully cover the additional recipients until 2020, when its share drops to 90 percent. Denton said that could eventually cost the state some $170 million annually. Currently, the feds pay about 70 percent of Kentucky’s Medicaid costs.
Denton said the health insurance exchange is projected to cost the state between $40 million and $50 million per year once federal assistance ends in 2015.
“This is something I think we need to have discussion on, we need input, we need to hear testimony, and it shouldn’t be left to the purview of one person in the state of Kentucky to make a paradigm change that is going to affect us for generations to come and have, ultimately, a huge impact on our budget,” Denton said.
Senate President Robert Stivers, R-Manchester, said Denton’s bills would begin in the health and welfare committee, but others, such as the appropriations and revenue committee, may have a say as well given the possible budgetary issues.
“Sen. Denton is on target when she says it may not cost us now, but when we start looking at 2016, 2017 and the years in the outer areas, it may have significant costs,” Stivers told reporters.
But the bills, if passed by the Senate, face long odds in the House.
House Speaker Greg Stumbo, D-Prestonsburg, said he would oppose any legislation that hinders implementation of the Affordable Care Act, commonly known as Obamacare. The federal health care reform package will improve the health of many Kentuckians, he said.
“Not only is it a good benefit to the state, it’s also something that morally we should do,” Stumbo said.
“I think once the facts are on the table that members will have a very difficult time voting against it.”
Kentucky “would be ill-served” not to take full advantage of the health care changes that would expand Medicaid coverage to additional uninsured residents, he said.
Beshear said insurers, hospitals and other stakeholders prefer the state operate its own health insurance exchange rather than one run by the federal government, he said.
Expanding Medicaid eligibility could be done through regulations in the state health plan, he said.
“What I’m doing right now is to try to gather all of the information I can to determine whether in the long run we can afford to expand Medicaid,” Beshear said.
The governor made one thing clear, though.
“Obviously if I determine we can afford to do it, I want to do it because Kentucky is one of the most unhealthy states in the country,” he said.
The Associated Press contributed to this report.