Gov. Matt Bevin’s pledge to dismantle Kynect, the state’s successful health insurance exchange, will probably be accomplished long before he secures an agreement with the federal government to make changes in the Medicaid expansion program.
While we’re hopeful Bevin will make significant improvements in the expanded Medicaid program, which is part of President Obama’s Affordable Care Act, we are less enthusiastic about his insistence to do away with Kynect.
Kynect and expanded Medicaid are the two main components of ACA, which is also called “Obamacare,” and both are optional to the states.
Kynect has been nationally recognized as one of the most efficient and successful programs to come out of the federal health care law. But Bevin has said Kynect is a duplication of services because there is already a federal exchange, HealthCare.gov.
The problem with Bevin’s argument is that he fails to follow a basic tenant of conservative philosophy, which is that most government services are best delivered at the local or state level rather than the federal level. With few exceptions, federal programs are inherently inefficient compared to state-run programs.
There is a legitimate concern among supporters of Kynect that Bevin is taking down the state exchange mainly because of its association with Obama, who is widely unpopular among Kentuckians.
At this point, it is unclear how much Kentucky will have to spend to dismantle Kynect, and that’s a question that needs to be settled before the state health exchange is shut down.
The previous administration, under Gov. Steve Beshear, estimated it would cost $23 million to dismantle Kynect. That figure is probably an over-estimate, but Bevin has not been able to give any estimate other than saying it will be “a small fraction” of Beshear’s figure.
Kentucky spent about $57 million in federal grant money to create Kynect. Shouldn’t the federal government expect some reimbursement from Kentucky for dismantling something built with federal dollars that is working so well?
And there are some questions about whether this plan will actually end the duplication of services that Bevin says he opposes.
Audrey Tayse Haynes, who was the health secretary under Beshear, recently said the state will have to maintain a call center for Kentucky residents in addition to the federal call center, Al Cross wrote for the Kentucky Health News blog. “We’re going to have a different kind of duplication of services,” she said.
Bevin isn’t likely to back down from his pledge to dismantle Kynect, but more and more, this does not look like a good move for the state.
Kentucky New Era