Health Care,  Stateside

Obamacare update: watch Kentucky

As I wrote here last July, I’m not a fan of the Affordable Care Act, aka Obamacare, which I still think is “much too complex and doesn’t do enough to hold down inflated medical costs.”

And events of the past several weeks– including the infamously malfunctioning website and President Obama’s now-discredited promise that everyone who likes their current health insurance can keep it– have not (to put it mildly) improved my opinion of the program or of Obama.

As he now acknowledges, the president seems to have been asleep at the switch in the months leading up to the rollout of the Healthcare.gov website and unaware of the approaching disaster. And when he promised that “if you like your health plan, you can keep your health plan,” he was either misinformed or glossing over the truth– and neither would be to his credit.

(In fact a small percentage of individual policies, which fail to meet the new federal standards and would fail to protect policyholders from financial ruin in case of a medical catastrophe, are being canceled. But before Obamacare, insurance companies were free to cancel policies too. And frequently did, without raising alarms from the Republicans.)

One of the things that makes Obamacare more complex than it should be is that 16 states have chosen to set up their own healthcare exchanges under the law, while 34 others have opted out, leaving their residents to try and deal with a federally-administered exchange. Some states have accepted expanded Medicaid coverage under the law, others have refused.

And, surprise: the law is working pretty well where the states are fully engaged.

The governors of Washington, Kentucky and Connecticut– three states that have set up their own exchanges– published an op-ed piece in The Washington Post expressing their confidence in Obamacare:

Tens of thousands of our residents have enrolled in affordable health-care coverage. Many of them could not get insurance before the law was enacted.

People keep asking us why our states have been successful. Here’s a hint: It’s not about our Web sites.

Sure, having functioning Web sites for our health-care exchanges makes the job of meeting the enormous demand for affordable coverage much easier, but each of our state Web sites has had its share of technical glitches. As we have demonstrated on a near-daily basis, Web sites can continually be improved to meet consumers’ needs.

The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding health-care coverage and have avoided the temptation to use health-care reform as a political football.

Politicians in other states, they observe, are “rooting for failure and directly undermining implementation of the Affordable Care Act.” The law is working best where state and local authorities want it to work.

While all three governors are Democrats, it’s worth noting that Kentucky has been a reliably pro-Republican “red state” in federal elections. Voters in the Bluegrass State sent Rand Paul to the Senate in 2010 and chose Mitt Romney over Obama in 2012 by a margin of 22 percent.

And yet:

Before ObamaCare, 640,000 Kentucky residents — or one-sixth of the state’s population — didn’t have health insurance. So Democratic Gov. Steve Beshear made it his biggest priority to ensure the law was in place and working properly.

“My state needs ObamaCare,” he wrote in a New York Times op-ed. “Now.”

The early results have been quite positive.

Despite its relatively small population, the Bluegrass State has enrolled more people in new health plans than almost any other in the nation…

Kentucky also accepted the federal government’s expansion of Medicaid under ObamaCare, and nearly 40,000 residents have already taken advantage of their new eligibility to sign up for it. And with a November surge, Kentucky is already beating its estimated enrollment pace, according to the Los Angeles Times.

Of course there are still problems with the Affordable Care Act that need to be fixed. Unfortunately Republicans are generally more interested in discrediting the program than in making it work better, most noticeably via a stream of negative stories which Ed Kilgore calls Anedctotageddon.

Also worth noting: while public approval of Obama and his health care plan has plunged in recent weeks, it’s still way ahead of Republicans in Congress.

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