A nonprofit publication of the Kentucky Center for Public Service Journalism

Bill Straub: Under a possible Clinton administration, Beshear’s influence on health care could increase


WASHINGTON – Word is that former Kentucky Gov. Steve Beshear, who was in charge when more than a half million previously uncovered Bluegrass residents were able to obtain some form of health insurance under the Affordable Care Act, is being considered for the job of secretary of the Department of Health and Human Services if Democrat Hillary Clinton wins the presidency.

Only a handful of Kentuckians have held the exalted position of cabinet secretary in recent times and it seems like family connections sure don’t hurt.

Elaine Chou, the wife of Senate Republican Leader Mitch McConnell, was the secretary of labor during the entirety of the President George W. Bush administration. Rogers C.B. Morton, a Republican originally from Louisville and the brother of U.S. Sen. Thruston Morton, R-KY, was secretary of commerce under President Gerald Ford after having served four years as secretary of the interior for President Richard Nixon.

Even then, Rogers was technically from Maryland, having served in Congress from that state.

Other than that, you probably have to go back to 1945 when newly-minted President Harry Truman named his poker playing buddy, Fred Vinson, of Louisa, secretary of the treasury. Vinson resigned after a short stay to become the 13th Chief Justice of the United States, where he generally is regarded as one of the worst to ever serve in that capacity.

Regardless, very few Kentuckians have risen to cabinet-level positions and a Beshear appointment would be the capstone to an unusual political career. A loyal Democrat, his name is probably being bandied about because of his success in implementing the Affordable Care Act in a state that is not always renowned for pushing through administrative ventures without taint.

Kynect, the state-based health insurance marketplace, was considered a model for the rest of the nation and he saw through a Medicaid expansion that added 440,000 residents of the commonwealth to the rolls.

Beshear left office in December and since then his successor, Republican Gov. Matt Bevin, has endeavored to treat the commonwealth’s health system much like Joshua treated the walls of Jericho. The system hasn’t come tumblin’ down quite yet, but Kentucky’s positive experience with Obamacare is reeling around like George Foreman in the eighth round of the Rumble in the Jungle. A crash seems imminent.

Bevin, for reasons known only to himself and the voices he responds to in his head, has already killed Kynect, forcing those who purchase insurance on the exchange to use the clumsier federal site. The Department of Health and Human Services reluctantly approved the abysmal move earlier this month, but not before heaping praise on Kynect and warning the governor that switching to the federal site, Healthcare.com, could result in user delays, gaps in coverage and confusion as Kentuckians adjust to a more complicated system.

Let them eat cake, says Bevin of his constituents.

And now, of course, the governor is playing a game of chicken with the federal government over the Medicaid expansion under Obamacare that has added 440,000 poor residents to the rolls. Bevin has threatened to end the initiative unless HHS bends to his will and approves a waiver from current regulations to impose, among other things, monthly premiums on Medicaid recipients of $1 to $37.50, a requirement that people work or volunteer up to 20 hours a week to maintain coverage, an elimination of coverage for some who fail to pony up and jettisoning dental and vision benefits after three months.

Rep. John Yarmuth, D-Louisville, apparently the adult in the room, has implored Bevin to retract the waiver, arguing that the feds won’t accept his terms, citing recent requests from Ohio and Arizona that were rejected by the Centers for Medicare and Medicaid Services, meaning the governor is toying with the health insurance coverage of the people he is supposed to be serving.

In a letter to Bevin dated Oct. 18, Yarmuth noted that Kentucky’s Medicaid expansion “is the national model of success and we should build on that progress.’’

“While we can debate the value of insuring more than 400,000 low-income Kentuckians, there is no longer any argument about the outcome of your current strategy. It will fail,’’ Yarmuth wrote. “You alone have the power to change course and redirect our commonwealth’s resources toward a plan that could move us forward and, hopefully, improve the lives of our fellow Kentuckians. I am pleading with you to withdraw your current waiver request.’’

Bevin, of course, answered in his typical rude and snotty way, asserting that Yarmuth “plays politics three weeks before an election.’’

“Gov. Bevin and his team have spent several months developing a transformative and financially sustainable Medicaid plan that will actually improve health outcomes for Kentuckians and encourage self-sufficiency,” said Amanda Stamper, his press secretary.

It should be noted, despite all his finagling and worthless rhetoric, Bevin has yet to put forward an idea or initiative to improve on the health of the 4.4 million people he represents. Instead, as noted by Save KY Healthcare, a group organized by Beshear to halt the assault, the governor is “once again putting his rigid right-wing ideology ahead of the health and well-being of Kentuckians.’’

Bevin isn’t the only Republican looking to do all that’s in his power to destroy Obamacare, which requires everyone to obtain health insurance, some with the help of subsidies provided by the federal government, or face a financial penalty. The GOP-led House has voted to repeal the law more than 50 times, with only the Senate, and the threat of a presidential veto, standing in the way.

Republican lawmakers insist they’re going to replace it, but with what is open to speculation. All this even though more than 21 million Americans have obtained some sort of health care coverage under the law. A higher percentage of people find themselves protected from potential financial disaster related to a health scare than ever before in the nation’s history.

Now those Republicans think they have additional ammunition. After several years of lower than normal increases in health insurance premiums, the industry is raising its rates by an average of 25 percent this year.

Despite expressions of outrage, the increase wasn’t unexpected. The average premium in Obamacare’s state exchanges in 2017 will be in the neighborhood of what the Congressional Budget Office anticipated. Insurers, with no background data to cite, basically guessed at what the market would look like and set premiums too low at the outset. The adjusted rates are now hitting expected levels as insurers seek to gain ground. Even so, some companies are pulling out of the marketplace.

“Families are stuck paying these higher premiums and Democrats only want to double down on Obamacare,’’ said House Speaker Paul Ryan, R-WI. Republican presidential candidate Donald Trump boldly declared that, as a result of the hikes, Obamacare is “over.’’

As with most things said by this joke of a candidate from New York City foisted on an unsuspecting public by the Republican Party, it probably isn’t going to turn out that way. A Kaiser Health Tracking Poll shows that a plurality of the general public still disapproves of Obama care but support shows signs of picking up – 44 percent approve while 47 percent disapprove. It’s basically breaking down along party lines – 74 percent of Democrats approve of the law, 76 percent of Republicans disapprove.

Regardless, it appears that relatively few Americans will actually take a major hit to their pocketbooks as a result of the premiums hike. According to FamiliesUSA, 85 percent of those who obtain insurance through the marketplace are eligible for, and are currently receiving, subsidies from the federal government.

Regardless, it appears that relatively few Americans will actually take a major hit to their pocketbooks as a result of the premiums hike. According to FamiliesUSA, 85 percent of those who obtain insurance through the marketplace are eligible for, and are currently receiving, subsidies from the federal government.

As a result of this assistance consumers are protected from spending more than a set share of their income on premiums — they will not face a price increase when a health insurance company hikes up its rates.

Medicaid and Medicare are federal programs that already cost enrollees nothing. They are completely protected from rate hikes. Remember, most of those who benefitted from Obamacare received coverage from the Medicaid expansion.

While some insurers have withdrawn from the marketplace, most consumers should still find multiple plans from which to choose. Just because one insurer’s prices are unaffordable doesn’t mean that all will be. And premium hikes are not universal – some areas are experiencing decreases.

Obamacare is working but it is far from perfect. Six years after passage most experts know what ails it and a few simple adjustments will cast the program on a calm sea. That’s not going to happen with a Republican House and a Senate that either has a GOP majority or the filibuster to stop any Obamacare initiative in its tracks – yet another example of placing party over country to the detriment of those who call the United States home.

This is the challenge Beshear will face if he actually earns the job. Some say, at 72, he’s likely too old, forgetting that the person who will make the nomination should she be elected, Hillary Rodham Clinton, turned 69 on Oct. 26.

Screen Shot 2015-09-03 at 8.27.46 AM

Washington correspondent Bill Straub served 11 years as the Frankfort Bureau chief for The Kentucky Post. He also is the former White House/political correspondent for Scripps Howard News Service. A member of the Kentucky Journalism Hall of Fame, he currently resides in Silver Spring, Maryland, and writes frequently about the federal government and politics. Email him at williamgstraub@gmail.com.


Related Posts

Leave a Comment