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Hurray for Kentucky!

Posted by John McDonough  September 27, 2013 09:19 AM

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And I don't say that very often. But today, I have a new hero.

It is Steve Beshear, the Governor of Kentucky who has an editorial in today's New York Timesbeshear.jpg titled "My State Needs Obamacare Now." Yes, Kentucky -- home state of Senators Mitch McConnell and Rand Paul, both arch-enemies of Obamacare. You can click and read, but this editorial is so darn good, I'm reprinting in toto below.

Not only does Beshear tout the economic benefits of the Affordable Care Act for Kentucky, he courageously highlights the reality that the health status of Kentuckians is among the worst in the nation, and that implementing the ACA is a cornerstone of a strategy to begin turning around the state's discouraging health indicators. I recall being at a conference for state legislators about a year ago and having the opportunity to converse with a senior legislative leader from Kentucky. I asked him, as politely as I could, how much folks inside Kentucky were concerned about the poor health status of the people.

"That's just because we have so many poor people," was his reply.

So, if they die early -- maybe that will improve the state's health indicators? [Head scratch]

Anyway, for something completely different, please read the wisdom of Governor Beshear:

FRANKFORT, Ky.  SUNDAY morning news programs identify Kentucky as the red state with two high-profile Republican senators who claim their rhetoric represents an electorate that gave President Obama only about a third of its presidential vote in 2012.

So why then is Kentucky -- more quickly than almost any other state -- moving to implement the Affordable Care Act?

Because there's a huge disconnect between the rank partisanship of national politics and the outlook of governors whose job it is to help beleaguered families, strengthen work forces, attract companies and create a balanced budget.

It's no coincidence that numerous governors -- not just Democrats like me but also Republicans like Jan Brewer of Arizona, John Kasich of Ohio and Rick Snyder of Michigan -- see the Affordable Care Act not as a referendum on President Obama but as a tool for historic change.

That is especially true in Kentucky, a state where residents' collective health has long been horrendous. The state ranks among the worst, if not the worst, in almost every major health category, including smoking, cancer deaths, preventable hospitalizations, premature death, heart disease and diabetes.

We're making progress, but incremental improvements are not enough. We need big solutions with the potential for transformational change.

The Affordable Care Act is one of those solutions.

For the first time, we will make affordable health insurance available to every single citizen in the state. Right now, 640,000 people in Kentucky are uninsured. That's almost one in six Kentuckians.

Lack of health coverage puts their health and financial security at risk.

They roll the dice and pray they don't get sick. They choose between food and medicine. They ignore checkups that would catch serious conditions early. They put off doctor's appointments, hoping a condition turns out to be nothing. And they live knowing that bankruptcy is just one bad diagnosis away.

Furthermore, their children go long periods without checkups that focus on immunizations, preventive care and vision and hearing tests. If they have diabetes, asthma or infected gums, their conditions remain untreated and unchecked.

For Kentucky as a whole, the negative impact is similar but larger -- jacked-up costs, decreased worker productivity, lower quality of life, depressed school attendance and a poor image.

The Affordable Care Act will address these weaknesses.

Some 308,000 of Kentucky's uninsured -- mostly the working poor -- will be covered when we increase Medicaid eligibility guidelines to 138 percent of the federal poverty level.

PricewaterhouseCoopers and the Urban Studies Institute at the University of Louisville concluded that expanding Medicaid would inject $15.6 billion into Kentucky's economy over the next eight years, create almost 17,000 new jobs, have an $802.4 million positive budget impact (by transferring certain expenditures from the state to the federal government, among other things), protect hospitals from cuts in indigent care funding and shield businesses from up to $48 million in annual penalties.

In short, we couldn't afford not to do it.

The other 332,000 uninsured Kentuckians will be able to access affordable coverage -- most with a discount -- through the Health Benefit Exchange, the online insurance marketplace we named Kynect: Kentucky's Healthcare Connection.

Kentucky is the only Southern state both expanding Medicaid and operating a state-based exchange, and we remain on target to meet the Oct. 1 deadline to open Kynect with the support of a call center that is providing some 100 jobs. Having been the first state-based exchange to complete the readiness review with the United States Department of Health and Human Services, we hope to become the first one to be certified.

Frankly, we can't implement the Affordable Care Act fast enough.

As for naysayers, I'm offended by their partisan gamesmanship, as they continue to pour time, money and energy into overturning or defunding the Affordable Care Act. It's shameful that these critics haven't invested that same level of energy into trying to improve the health of our citizens.

They insist that the Affordable Care Act will never work -- when in fact a similar approach put into effect in Massachusetts by Mitt Romney, then the governor, is working.

So, to those more worried about political power than Kentucky's families, I say, "Get over it."

The Affordable Care Act was approved by Congress and sanctioned by the Supreme Court. It is the law of the land.

Get over it ... and get out of the way so I can help my people. Here in Kentucky, we cannot afford to waste another day or another life.

Steve Beshear, a Democrat, is the governor of Kentucky.

Could not have written it better myself!  Congratulations Governor!!

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »

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