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Kentucky's Medicaid Expansion Closes Economic Gap For Insurance, Poll Says

Jennifer Morrow/Creative Commons

The expansion of Medicaid has closed an economic gap for health insurance in Kentucky, accord to the latest Kentucky Health Issues Poll.

The poll shows more lower-income adults have become eligible for insurance since the implementation of the Affordable Care Act and the expansion of Medicaid. In 2013, before the expansion took effect, more than three in 10 adults earning less than 200 percent of the federal poverty level were uninsured.

Now, only one in 10 adults earning that same amount are uninsured, according to the poll.

Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, said the ACA and Medicaid expansion are a step towards health equity in Kentucky.

"What this is doing is improving the equity to access in health care by reducing those gaps between lower income people who have insurance and the number of higher income people who have insurance," said Zepeda.

Uninsured rates are now about the same for all Kentucky adults regardless of income, according to the poll.

The poll focused on Kentuckians aged 18 to 64. Nearly all Kentuckians 65 and older are insured.

Soon after taking office in December, Republican Gov. Matt Bevin said his administration would begin working on a plan that would reform Medicaid in the state. He said the proposal would include a requirement for many recipients to pay for a portion of their coverage.

The percentage of people insured through an employer dropped in 2015, with 41 percent of individuals reporting being insured by their employer or their spouse's employer.

Zepeda said KHIP polls between 2008 and 2013 that  have asked about employer provided insurance, show a "bumpy road."

"Back in 2014, we could say that half of the people we talked to in the survey did have employer-provided insurance," she said.

In 2015, 35 percent of Kentucky adults received some form of public insurance, including Medicaid, Medicare, military benefits, or a combination of the three, which is an increase from 29 percent in 2014.

The poll also looked at stability of health insurance among Kentucky adults. Stability of health insurance examines whether a person has continuous insurance coverage for the past 12 months. In Kentucky, eight percent lacked insurance sometimes in the past year.

Zepeda said if people have steady coverage, they are more likely to have a usual source of care.

"If you have gaps in your health insurance coverage that means there are times when you may go without care or you may wait til you're really sick and then try to access care, for example, in an emergency room," she said.

Overall, the rate of uninsured Kentucky adults dropped from 25 percent in 2013 to 12 percent in 2014, according to a comparison of KHIP polls. The state's uninsured rate is 13 percent, according to KHIP.

According to Gallup-Healthways Well Being Index, Kentucky’s uninsured rate was 20.4 percent before ACA implementation. Now, it’s 7.5 percent.