Held less than a month shy of the primary election, the debate at Western Kentucky University in Bowling Green featured Agriculture Commissioner James Comer, Louisville businessman Matt Bevin, and former Louisville Metro Councilman Hal Heiner.
Comer said the state took on a lot of responsibility with the exchange, known as Kynect, that it can’t afford.
"Eighty-two percent of the people who got on Kynect ended up on Medicaid," Comer said. "What Kynect became for Governor Beshear was a way to greatly expand Medicaid to the point to where we have 25 percent of the state on Medicaid, one out of four people. That's not sustainable."
As governor, Comer said he would get more Kentuckians into private health coverage while changing eligibility requirements for Medicaid.
Matt Bevin said he would transition those who signed up on Kentucky’s exchange to the federal exchange.
"Frankly, it's a level of redundancy we can't afford. It's as simple as that," Bevin said. "We were lured into participation through the use of federal dollars."
Starting in 2017, the state must begin bearing a share of the cost of expanding Medicaid. Currently, the federal government is picking up the entire tab.
Heiner suggested tying the Medicaid expansion to workforce training so people could get a job, get off of Medicaid, and obtain private insurance. He criticized the Medicaid expansion for lacking any level of personal responsibility.
"It doesn't have what you're seeing conservative governors in other states adopt in their plans, which build in incentives to use preventive care, to use primary care providers rather than emergency care, and to make healthy lifestyle choices to reduce the overall cost," Heiner stated.
The candidates were mostly in agreement on range of economic topics, from making Kentucky a right-to-work state to protecting the coal industry.
The other GOP gubernatorial candidate, Will T. Scott did not attend the debate, citing a scheduling conflict.