In rural Kentucky, health-care debate takes back seat as the long-uninsured line up


BREATHITT COUNTY, Ky. — On the campaign trail, Senate Minority Leader Mitch McConnell was still blasting the new health-care law as unsalvageable. At the White House, President Obama was still apologizing for the botched federal Web site.

But in a state where the rollout has gone smoothly, and in a county that is one of the poorest and unhealthiest in the country, Courtney Lively has been busy signing people up: cashiers from the IGA grocery, clerks from the dollar store, workers from the lock factory, call-center agents, laid-off coal miners, KFC cooks, Chinese green-card holders in town to teach Appalachian students.

If the health-care law is having a troubled rollout across the country, Kentucky — and Breathitt County in particular — shows what can happen in a place where things are working as the law’s supporters envisioned.

One reason is that the state set up its own health-insurance exchange, sidestepping the troubled federal one. Also, Gov. Steve Beshear (D) is the only Southern governor to sign on to expanded eligibility parameters for Medicaid, the federal health-insurance program for the poor. The less technical reasons involve what Lively told Noble next.


Are they on Medicaid?


We’re not given that information, but if that county really is one of the poorest in the state, one would expect so.

A peculiarity of medicaid is that you can sign up for it AFTER incurring healthcare costs, and it applies retroactively. For that reason, a lot of people who are eligible for it don’t sign up until they incur medical bills. I’m not sure that’s true of the expanded Medicaid, but it might be thought so, at least.

It’s possible the big signup in that Ky county is largely people who were always eligible, who had just not yet signed up, but who are now doing so because encouraged to do so by the Obamacare recruiters.

Without more information, we can’t know what this represents.


Thanks for the info.


From the article (link is here…not provided by the OP):
In a state where 15 percent of the population, about 640,000 people, are uninsured, 56,422 have signed up for new health-care coverage, with 45,622 of them enrolled in Medicaid and the rest in private health plans, according to figures released by the governor’s office Friday.
They are touting this as a success? They are touting that, after all the millions they’ve spent on marketing, they still have 583,576 uninsured?

Also, I wonder if the 640,000 number cited by the Post includes the 300,000 who lost their private insurance in Kentucky due to Obamacare? Per CNN:
…about half of the roughly 600,000 people in Kentucky’s private insurance market will have their current insurance plans discontinued by the end of next year…
So, if I have this right, this great success touted by Obamacare apologists is that 10,800 people signed up for Obamacare (excluding Medicaid)…and 300,000 people lose their insurance.

Did anybody teach these leftists math?


I think it is good that they are getting health insurance but I am still opposed to Obamacare because of the HHS Mandate.


I think that’s the most confusing part of the application. How does one know what his 2014 income will be when he may not even know exactly how much income he will receive in 2013?


My guess is that people who previously could have signed up for Medicaid but didn’t because they didn’t have to, would still need to go through the county welfare office to sign on.

It is my impression if you sign on through Obamacare, you don’t. Now, whether people who previously would have signed up through the welfare office can now sign up directly through the website without going to the welfare office is something I don’t know.

Basically, of those who signed up for Medicaid, we don’t know how they did it or whether they are part of the 17 million estimated (I’m guessing more) to be added to Medicaid through Obamacare. But it’s my impression that nobody checks your income for Obamacare.

But this story reminds me somewhat of the “food stamp solicitors” this administration sent out all over the place to get more people on food stamps than would have otherwise signed up for them. Probably they’re doing the same thing with Medicaid now. Sounds like it.


Insurance won’t mean much if you have a high deductible and can’t get access to a doctor because they refuse to be told by Washington what to do.

Wonder how long it took the OP to find an article with a pro-ObamaCare slant. :smiley:


Yes we do.

Bill O’Reilly said it best:

“By this time next year, 35% will approve and 65% will disapprove. The 65% will be paying for the 35%.”


Sweet, 85% Medicaid signups! That’s the financial lynchpin that will assure this puppy’s success.


In theory, insurance companies have fee agreements and contracts with the doctors and hospitals already. Deductibility is the patient’s problem. This is all under the jurisdiction of the state commissions and regulators. Washington may try to intravene but will soon discover that that is not a good idea.


It was quite easy. …ran on to it while lookingxfor info on Downton Abbey.

There’s still a year to find many more or begin the moves toward single-payer. In the states with their own exchanges and expanded Medicaid, it seems like things are doing better. I wonder how that will play in Nov. 2014


From the very beginning, I have believed Obamacare is fundamentally an income redistribution plan, and nothing more. It’s not a healthcare plan or even an insurance plan. It’s a shift of income from one segment of the middle class to another segment of the middle class.

The truly poor will not be benefitted in theory, but as a practical matter they will be harmed by the “crowding out” caused by adding millions of new people onto Medicaid rolls; some number of which would have had employment-based insurance.


“Redistribution is a loaded word that conjures up all sorts of unfairness in people’s minds,” said William M. Daley, who was Mr. Obama’s chief of staff at the time. Republicans wield it “as a hammer” against Democrats, he said, adding, “It’s a word that, in the political world, you just don’t use.”

These days the word is particularly toxic at the White House, where it has been hidden away to make the Affordable Care Act more palatable to the public and less a target for Republicans, who have long accused Democrats of seeking “socialized medicine.” But the redistribution of wealth has always been a central feature of the law and lies at the heart of the insurance market disruptions driving political attacks this fall.


But if I remember correctly, companies outsourcing jobs because of the cost of their insurance coverage was what prompted healthcare reform in the first place. Unfortunately Obamacare has not made the American companies more competitive in the international business world and unemployment will continue to be a big problem for quite some time.


The new healthcare law does not allow a person to retroactively apply medicaid or any health insurance policy to prior medical bills. A person must sign up during the sign up window or go without health insurance until the next years sign up window. This is to discourage people from abusing the system.


Obamacare was intended as a cure for unemployment? If so, (and that’s not the way it was promoted that I ever saw) it does exactly the opposite of what it was supposedly intended to do.


Are you sure about this? It has been my impression that a person can sign up after the “window”, but he will pay at least a partial fine for failing to sign up during the window period.


it seems like things are doing better. I wonder how that will play in Nov. 2014

Not well for the democrats. They overhauled the system to “make things better” for less than 1/3 of the population, and even that will be a moot point once doctors deny access because the government won’t pay them.

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