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Beyond the Numbers, Kentucky's Beshear Brings Healthcare Success Stories to State Fair

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In the twilight of his term of office, Kentucky Gov. Steve Beshear is savoring the political fruits from a leap of faith made 15 months ago, when he spurned his Legislature and opted to expand Medicaid, citing a unique provision in Kentucky regulations. A year after the CMS visit, Beshear and his team are the subject of glowing reports, which describe how a commonwealth with a history of getting things wrong in healthcare has done just about everything right in Obamacare.

Exactly a year ago today, on Aug. 22, 2013, a team of inspectors from the Centers for Medicare and Medicaid Services (CMS) arrived at the Kentucky capital in Frankfort, to see for themselves if the commonwealth could pull off one of the great healthcare successes in history. As TIME reported earlier this month, perhaps it should have been the other way around.

In the twilight of his term of office, Kentucky Gov. Steve Beshear is savoring the political fruits from a leap of faith made 15 months ago, when he spurned his Legislature and opted to expand Medicaid, citing a unique provision in Kentucky regulations. A year after the CMS visit, Beshear and his team are the subject of glowing reports, which describe how a commonwealth with a history of getting things wrong in healthcare has done just about everything right in Obamacare.

Most of the early reports focused on the smooth functioning of the Kentucky exchange and the solid enrollment numbers. But what about health outcomes? Kentucky officials say that part is happening, too, and yesterday Beshear brought some of those tales to a premier Kentucky political event, the Kentucky Farm Bureau Ham Breakfast at the state fair in Louisville.

The governor told the story of Frank and Renee McAninch, a farm couple who previously had been unable to afford insurance. After years of putting off having a spot on his faced checked, Frank McAninch could finally afford to see a doctor and learned he had skin cancer. McAninch had the spot removed.

Delays in cancer screening and treatment are precisely the issues Beshear took aim at a year ago when he expanded Medicaid, as reported in the August 2013 issue of Evidence-Based Oncology, a publication of The American Journal of Managed Care. As Beshear said then, “A multitude of state and national reports have shown the positive impacts on health status that occur when an individual becomes insured. They are more likely to get preventive care and seek out medical treatment when they need it.”

Beshear’s healthcare team began with a simple idea: Kentucky would do everything the law called for, they just wouldn’t call it Obamacare or even the Affordable Care Act. Here, it’s called Kynect, and the exchange is credited with enrolling more than 421,000 residents during open enrollment, according to Kerri Richardson, spokeswoman for Governor Beshear.

An Aug. 5 Gallup poll cited Kentucky and Arkansas for having the largest drops of uninsured, which set off the series of stories and the visit from TIME magazine. Beshear’s success has complicated things in the US Senate race between Democrat Alison Lundergran Grimes and Republican Minority Leader Mitch McConnell, who has said he opposes the ACA but that those who have signed up for Kynect should not lose their insurance.

To be sure, not every Beshear critic has gone away. Plaintiff David Adams continues to pursue the administration in court over its May 9, 2013, decision to accept up to $15.6 billion in additional Medicaid funds. But Adams’ filings have gained little traction and get no coverage from the state’s press corps.

The governor took care yesterday to address those in the farm community who have not embraced the ACA. According to the Richmond (Ky.) Register, Beshear quoted statistics that show 30,000 residents who live in one of the five counties with the highest farm cash receipts have secured insurance under the law.

“Kynect lowers cost — and Kynect saves lives,” Beshear said.

Around the Web

Leveraging Health Reform to Combat a History of Cancer: Kentucky to Expand Medicaid, Increase Clinical Trials as U of K Markey Center Gains NCI Status

How Kentucky Got Obamacare Right

Arkansas, Kentucky Report Sharpest Drops in Uninsured Rate

Beshear Gives Examples of Farmers Helped by Obamacare

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