Poll: Kentuckians favor Medicaid expansion

Deborah Yetter | Louisville Courier Journal

A new poll shows a significant majority of Kentuckians favor keeping the expansion of Medicaid under the Affordable Care Act that new Gov. Matt Bevin has pledged to scale back.

The poll released Friday by the Kaiser Family Foundation shows 72 percent of Kentuckians favor keeping the Medicaid expansion under the federal law also known as Obamacare that has provided health coverage to about 425,000 residents.

A smaller majority, 52 percent, favors keeping kynect, the state online health insurance exchange that Bevin has pledged to dismantle saying he plans to transition Kentuckians to the federal site to shop for health coverage.

The poll found support for the Medicaid expansion varied on party lines but found support in all major groups.

Of Democrats, 89 percent said they support keeping the Medicaid expansion. Of Independents, 75 percent supported keeping it, and 54 percent of Republicans favored it.

The results delighted health advocates who hope to persuade Bevin to reconsider his plans to shift to an Indiana-style Medicaid program with tiers of coverage, co-pays, premiums and potential cancellation of people who miss payments. Kentucky's expanded Medicaid program is largely free to most Kentuckians and available to anyone making less than about 138 percent of the federal poverty level.

"I hope Gov. Bevin is paying attention to these findings and listens to the people," said Bill Wagner, executive director of Family Health Centers in Louisville. "I hope we won't blindly follow the Indiana model. I think it's a race to the bottom."

The Bevin administration did not respond to a request for comment Friday.

But in his inaugural speech Tuesday, the new governor repeated his pledge to reshape Kentucky's Medicaid program, as his fellow Republican, Indiana Gov. Mike Pence, an invited guest, sat on the VIP platform.

"I intend to copy the best parts of what they are doing," Bevin said of Indiana, which obtained a waiver from the federal government to create its own, more limited plan. "We will be better for it. Our people will be better for it."

Wagner said he fears a complicated plan with co-pays and premiums will discourage low-income people from participating. Wagner said he would rather see Kentucky design its own program if the Bevin administration insists on changes.

"We should think more creatively and pursue a Kentucky model," he said.

Emily Beauregard, executive director of Kentucky Voices for Health, a coalition of advocacy groups, said she found the Kaiser poll results "really encouraging."

"We're excited to see that so many people want to keep the Medicaid expansion," Beauregard said. "I hope it will shift the conversation."

Kentucky was the only Southern state to launch its own health care exchange and accept the Medicaid expansion under the federal law. Gov. Steve Beshear, a Democrat who just left office, initiated it through executive order.

Bevin ran a campaign pledging to scale back the Medicaid expansion after backing off an initial claim he would repeal it.

The Kaiser poll, taken before Bevin was inaugurated Tuesday as governor, also found about half of Kentuckians have an unfavorable view of the federal health law, which has been attacked relentlessly by Republican politicians.

"Kentuckians don't particularly like the Affordable Care Act, but they do like their state's Medicaid expansion and marketplace and most want to keep them," said Drew Altman, president of the Kaiser foundation, a nonprofit that follows health issues.

The poll also found few Kentuckians have a good understanding of the federal health law.

For example, only 16 percent of the about 1,000 Kentuckians interviewed for the poll realized that the federal government pays most of the costs of the Affordable Care Act.

It covers 100 percent of Kentucky's costs of the Medicaid expansion through 2016. The federal share drops to 95 percent in 2017, declining to 90 percent in 2020 and beyond.

Also, 37 percent of those polled said they believe the law and the Medicaid expansion have caused people to lose health insurance. In fact, Kentucky boasted the sharpest decline of any state in the rate of uninsured citizens, dropping from 20.4 percent to 9 percent of people with no health coverage under the new law.

Still, the poll found that overall, Kentuckians hold a positive view of Medicaid, the federal-state health plan for the poor, disabled and low-income elderly in nursing homes.

A majority believe Medicaid is working well and very important, it said.

Of those who believe Medicaid is important, the poll said, eight in 10 say they believe that because "someone they know has received health care paid for by Medicaid."

Contact reporter Deborah Yetter at (502) 582-4228 or at dyetter@courier-journal.com.