, Corbin, KY


January 31, 2014

Obamacare in Kentucky: Free cards but quality care?

CORBIN — My pride as a Kentuckian at seeing our small state get a sliver of the national spotlight during President Obama’s State of the Union speech was tempered by some sobering truths.

Obama praised Gov. Steve Beshear for being “like a man possessed when it comes to covering his commonwealth’s families” through implementation of a state-run health care exchange that’s part of the federally mandated Affordable Care Act.

Not mentioned in the praise is the fact that the governor’s administration received $253.7 million in federal funding to establish the new health care bureaucracy that so far has primarily served to expand Kentucky’s bloated Medicaid rolls.

Beshear may seek a perception that portrays himself as a papaw doting over us grand kids to make sure he’s taking good care of us. But how do taxpayers in Indiana, Tennessee and Ohio feel about being forced to fund a government-run exchange that offers coverage to uninsured residents of another state but little hope that critically needed health care actually will be accessible to – and received by – those needy citizens?

The governor touts that 182,000 previously uninsured Kentuckians have signed up for coverage since October 1. But he often fails to mention that only one in four of those new signees purchased private health insurance.

The rest joined Medicaid, meaning that the longest long line for free government stuff in the commonwealth no longer wait behind a truck delivering Washington-provided cheese. Instead, the line now has moved to receive free health goodies, courtesy of Frankfort.  

“If you want to give out free health care, you’re going to have a lot of interest – just like free anything else,” Sen. Mitch McConnell, R-Ky., said during his weekly press briefing in response to a question about the Beshear administration’s implementation of the new health-care plan.

McConnell noted that while there’s been a Herculean effort to “paint a pretty picture” of Kentucky’s foray into Obamacare, “the rollout is quite mixed, quite mixed, and largely people signing up for Medicaid – free health care.”

Actually, at least some cheese – and pretty good cheese, I’ve been told – came off those big gas-hogging government trucks.

The senator, however, may even be too optimistic in calling the product that new Medicaid enrollees receive as “care.”

In fact, if they were honestly candid, Kentucky’s Obamacare supporters would, among all of their cheerleading, include this caveat to new Medicaid enrollees: “We promise you will have free coverage, but we cannot ensure free – and certainly not prompt – care.

“You should know that a technology firm hired by the state just as Gov. Beshear was expanding Medicaid last year by executive fiat – in the finest tradition of his White House comrade – said swelling of the program’s rolls likely will worsen the state’s shortage of physicians.

“And considering that Deloitte Consulting report showed that Kentucky already was short 3,800 primary care physicians and specialists – which were needed just to meet health care demands before the governor’s Medicaid expansion – you can understand why we can’t guarantee actual care.

“After all, if there weren’t enough doctors before, how dire could the situation become when, as a result of the governor’s executive order, 300,000 more people seek free health care? But hey, we’ll cross that hospital when we get there. For now, just feel good about everyone having an insurance card and how that Big Daddy Government intends to look out for you.

“In the meantime, we Obamacare supporters in Frankfort will enjoy the political benefits and hope the folks don’t figure all of this out either ahead of the next election or before we retire.”

Jim Waters is president of the Bluegrass Institute, Kentucky’s free-market think tank. Reach him at Read previously published columns at

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