Health

More than two-thirds of Kentucky residents don’t want the state to roll back its expanded Medicaid system, according to a poll released Friday.

The Kaiser Family Foundation poll also shows that half of Kentucky residents hold unfavorable views of the Affordable Care Act, the federal law that allowed the state to expand Medicaid.

“Most of them would rather keep Medicaid as it is today than scale it back to cover fewer people,” said Liz Hamel, director of public opinion and survey research at Kaiser.

The poll found 72 percent of Kentuckians don’t want to scale back Medicaid expansion to cover fewer people.

Kentucky’s Medicaid expansion — and its fate — are a closely watch component of Gov. Matt Bevin’s administration. Bevin, a Republican who took office Tuesday, campaigned reforming the state’s adoption of the Affordable Care Act.

Among Republicans, 54 percent favor keeping Medicaid expansion as it is over changing it to reduce the number of people with coverage, according to the poll. Of people who voted for Bevin, 43 percent support the current Medicaid program, while 50 percent want it scaled back to cover fewer people.

A majority of Democrats and independents want the state’s Medicaid program to operate as it currently does, with 89 percent and 75 percent, respectively, favoring the current program.

“The law has been talked about in such a political context that people’s view of it tend to line up with their party affiliation,” Hamel said.

Dewey Clayton, professor of political science at University of Louisville, said Kentuckians are sending a clear message to Bevin that they want to keep Medicaid expansion.

“I think that’s sort of going to force the governors hand. And I think he will tinker around the margins somewhat and make a few changes but for the most part not scale it back nearly as significantly as he at one point was talking about doing on the campaign trail,” Clayton said.

Bevin has said he believes Kynect, Kentucky’s health insurance exchange, is redundant and wants to dismantle it by the end of 2016. He also  plans to roll back the state’s expansion of Medicaid, saying the expanded program will become too costly once the state is required to pick up part of the tab from the federal government.

Bevin has said he intends to apply for a Section 1115 Medicaid waiver from the Centers for Medicare and Medicaid Services. The waivers give states more flexibility in how they operate their Medicaid programs. And they provide states with an avenue to test new approaches in Medicaid that differ from federal program rules, according to a brief by Kaiser Family Foundation.

When it comes to Kynect, 52 percent of the poll’s respondents say they want to keep the state’s health insurance exchange. A quarter of residents want the state to switch to the federal marketplace, healthcare.gov.

Republicans are more divided on Kynect — 38 percent wanting to switch to the federal marketplace and 35 percent wanting to keep Kynect. Among those who report voting for Bevin, 53 percent want to switch to the federal marketplace  compared to 24 percent who want to keep the state-run marketplace.

Majorities of Democrats  and independents prefer to keep Kynect, according to the poll.