Uninsured adults in Kentucky had a lot to gain from Medicaid expansion, study says

Small towns and rural counties benefited the most
Posted at 1:57 PM, Oct 02, 2018
and last updated 2018-10-02 17:57:54-04

Medicaid expansion dramatically changed the outlook for low-income, uninsured people in Kentucky, according to a new study on the role of Medicaid expansion.

The study points to a “striking” reduction in the rate of uninsured adults living in small towns and rural counties.

The Georgetown University Health Policy Institute Center for Children & Families conducted the study. According to its report, the uninsured rate for low-income adults has decreased in nearly all U.S. states since 2008-2009. But the sharpest declines were seen in small towns and rural populations, from 35 percent to 16 percent in 2015-2016.

The study defines low-income adults as those living below 138 percent of the federal poverty level.

Kentucky, an early adopter of Medicaid expansion, experienced one of the biggest drops in the uninsured rate in rural areas, researchers found.

It was during the same time frame that former President Barack Obama signed the Affordable Care Act, also known as Obamacare, into law in 2010. The law required Americans to obtain insurance or pay a fine. It greatly expanded Medicaid in most states as well. Former Democrat Gov. Steve Beshear chose to expand the state’s Medicaid roll to cover able-bodied adults in the first year permitted under the ACA.

The study on Medicaid expansion comes amid concerns over Medicaid in Kentucky.

Faced with a budget shortfall, Republican Gov. Matt Bevin proposed a plan to overhaul Kentucky’s Medicaid program to include work, volunteer and education requirements for people receiving benefits. A federal judge has since blocked those changes before they could take effect in July.

According to the Georgetown University findings, the uninsured rate for low-income adults in Kentucky fell from 43 percent in 2008-2009, to 13 percent in 2015-2016, greatly reducing the gap between uninsured people living in metro areas versus rural communities.

Still, thousands of Kentuckians remain in poverty. More than 1.4 million people receive Medicaid benefits in Kentucky, or about one-third of the state's population.

The chart below shows the Kentucky counties with the most uninsured adults in 2015-2016, according to the study:

Overall, researchers concluded that Kentucky’s rate of low-income, uninsured adults evened out to 13 percent under Medicaid expansion. The study does not address the specific budget shortfall Kentucky is facing.