Gov. Andy Beshear has announced he's planning to restart Kynect, the state-based health insurance exchange that allows people unable to get coverage through an employer to enroll in a health insurance plan or sign up for Medicaid if they qualify. Former Gov. Matt Bevin dismantled the program in 2017.
Currently, said Cara Stewart, director of policy advocacy at Kentucky Voices for Health, Kentuckians who want be insured through the Affordable Care Act have to apply through the one-size-fits-all federal platform on healthcare.gov. She said the state has no local control to tailor coverage to the needs of Commonwealth residents.
"Having your own state-based marketplace means that you have the final answer in Kentucky. It means that you can decide when to have open-enrollment periods," she said. "It would have meant that we could have had a special open-enrollment period because of the COVID-19 pandemic. We could have created an opportunity for people to enroll in coverage."
The federal government has so far refused to open a special enrollment period for health coverage through the ACA amid the pandemic. One study from Families USA estimated that, between February and May, more than 5 million Americans lost health coverage as a result of losing their jobs.
Stewart said an open-enrollment period for the state-based marketplace is likely to begin in fall 2021.
Northern Kentucky resident David said that for him and his wife, the current process has been time-consuming and confusing.
"What does make it complicated is we kind of have to navigate two completely different systems," he said, "one for me, for my Medicaid, and a totally different system for Marketplace."
Stewart said David's experience isn't unique, since the lack of a state-based system means more work for consumers. She said some people simply get discouraged and give up.
"Everything changes when you have to say, 'Well, if your income is above or below this line, then you're probably going to need to go through this website; and if it's above or below this amount, then you're probably going to go to this place. But we won't know for sure until we do it, and you might have to fill out two applications,'" she said.
The estimated $5 million plus operating costs to revive Kynect will be far lower than the roughly $10 million per year the state now pays to purchase health plans through healthcare.gov, Stewart said, a price tag set to increase to $15 million.
Beshear's Letter of Intent is online at governor.ky.gov.