Kentucky’s Medicaid Oversight Board Evaluates State Health Exchange Kynect

Introduction: The Future of Kentucky’s Health Exchange

In a recent meeting of the Kentucky Medicaid Oversight and Advisory Board, questions arose regarding the efficacy and sustainability of kynect, the state’s health insurance exchange. Administrators faced skepticism about the advantages of maintaining a state-level exchange in contrast to utilizing federal platforms.

The Origins and Benefits of Kynect

Kynect was initiated by former Governor Steve Beshear under the Affordable Care Act (ACA), offering a centralized platform for Kentucky residents to access various health and social services. According to Lisa Lee, Commissioner for the Department of Medicaid Services, this state-based system significantly streamlines the application process.

“When we operated on the federally facilitated marketplace, families had to fill out another application when their circumstances changed. Kynect allows for smoother transitions,” Lee explained.

Simplified Access to Resources

Through kynect, Kentuckians can easily access qualified health plans, advance premium tax credits, food assistance, Medicaid services, and child care aid. This single-platform approach potentially reduces confusion among users, promoting better resource utilization.

Concerns about Cost and Funding

Despite the reported benefits, some board members expressed apprehensions regarding the financial implications of maintaining kynect. Republican co-chair Senator Julie Raque Adams questioned officials on whether the program incurs any costs to the state General Fund.

“Is it your testimony that there is not even one dollar of General Funds that goes to execute this state-based exchange?” Adams asked, seeking clarity on the funding structure.

In response, David Verry, the assistant director of the Division of Health Plan Oversight, affirmed that kynect costs the state nothing. Its funding comes from a percentage of insurance premiums and was initially developed with federal support.

Historical Context: Kynect’s Past Challenges

The exchange has faced its share of challenges. Former Governor Matt Bevin attempted to dismantle kynect in 2016, opting to use HealthCare.gov instead. This move included halting marketing efforts that promoted kynect, a strategy later reversed by Governor Beshear, who praised kynect as “the gold standard.”

Identifying Issues: Eligibility and Access

Verry highlighted a troubling consequence of the previous shift to HealthCare.gov, noting that nearly 9,000 Kentuckians eligible for Medicaid were unaware of their qualification, resulting in unnecessary costs for them.

“When we returned from HealthCare.gov, there were nearly 9,000 Kentuckians who were Medicaid eligible but didn’t know it,” Verry said, emphasizing the platform’s lack of awareness regarding eligibility.

Questions About Effectiveness Versus Federal Platforms

GOP board co-chair Representative Ken Fleming raised concerns over potential flaws in the state-level kynect portal compared to its federal counterpart. He pointed out that some users might erroneously qualify for Medicaid due to issues in the system’s verification processes.

While acknowledging the flexibility of a state-run exchange, Fleming also noted the strict eligibility checks and rich data resources within the federal marketplace.

Assurance on Data Integrity

State officials assured the board that they leverage federal databases for verifying eligibility, aiming to mitigate any discrepancies in applicants’ information. This emphasis on accuracy is essential in ensuring that Kentucky residents receive the benefits they are entitled to.

Exploring Alternatives: A Hybrid Approach?

Vickie Yates Glisson, a nonvoting member of the board, suggested the possibility of a hybrid system that provides local assistance while utilizing the federal platform. Glisson previously served as Bevin’s secretary of health and human services and is familiar with the benefits and drawbacks of both systems.

“There are several states that have adopted the federal platform, which alleviates the need for staffing and IT overhead,” Glisson explained.

Resistance to a Simplified Solution

Verry countered this idea by asserting that transitioning to a federally facilitated marketplace would still results in inefficiencies, complicating access to diverse benefits across different pools.

“Unfortunately, it’s not quite as simple as that,” Verry said, reiterating that maintaining a state-based exchange is crucial for minimizing bureaucratic hurdles for users.

Conclusion: The Ongoing Debate

As Kentucky continues to navigate the complexities of health exchange management, the future of kynect remains a topic of considerable discussion. The Medicaid Oversight and Advisory Board will likely continue to deliberate on the most effective approach to ensure that Kentucky residents receive streamlined access to essential health and social services.

With state government and politics reporting supported in part by the Corporation for Public Broadcasting, the ongoing dialogue will be essential in shaping the future of Kentucky’s healthcare landscape.