The future of Kentucky's health insurance exchange is being analyzed by the state's outgoing and incoming administrations.
Gov. Steve Beshear and Governor-elect Matt Bevin have drastically different views of Kynect, the health care exchange Beshear established under the Affordable Care Act. While they consider the future of the program, others are thinking about what dismantling Kynect may mean for them and their neighbors.
Doug Justice is a "Kynector" based in Jackson County in Eastern Kentucky. His job is to help residents sign up for insurance through Kynect. Twice a week, he can be found at Jackson Public Library helping people enroll in a health insurance policy.
Justice said he's concerned about Bevin's pledge to dismantle the state's health insurance exchange, which he could accomplish by the end of 2016 at the soonest.
"There's a ton of people that's on it, and you just can't say, 'OK, you don't have insurance anymore,'" he said, adding that he hopes Bevin's administration will soften its stance against the health care overhaul.
In Jackson County, 50 percent of residents have Medicaid, which includes 2,021 people who have gained insurance through the ACA's Medicaid expansion and 4,584 individuals who are enrolled in traditional Medicaid. About 300 people are enrolled in a qualified health plan through Kynect.
Since 2013, more than 500,000 Kentuckians have enrolled in a qualified health plan or Medicaid expansion through Kynect.
Bevin has the state’s health insurance exchange is redundant because Kentuckians can get similar access to health insurance plans via the federal exchange. He also said the state cannot afford the cost of the Medicaid expansion once the federal government begins requiring states to pick up the tab for the additional recipients. That cost is estimated at $409 million annually beginning in 2020.
The governor-elect has yet to reveal specific plans for how he would roll back the Medicaid expansion, but he has recommitted since his election earlier this month to dismantling the insurance exchange.
Like thousands of Kentuckians who've recently gained health insurance, the prospective changes mean uncertainty for Justice, too. He is employed as a Kynector through the Kentucky River Foothills Development Council. He said he would no longer have a job if Kynect closed. But he's not convinced that will happen.
"I don't think they'll do completely away with it. I think they'll revamp it, change it around some, and that's fine," Justice said.
Audrey Haynes, secretary of the Kentucky Cabinet for Health and Family Services, recently said nearly 175 employees of a Kynect a call center in Lexington may also lose their jobs if the exchange is closed.
She said changes to the health care exchange may also affect insurance agents, who sold more than 50 percent of private health plans.