A nonprofit publication of the Kentucky Center for Public Service Journalism

With nine of top 10 rural counties for enrollment, Kentucky relies heavily on Medicaid expansion

By Mary Kuhlman
Public News Service

Newly crunched data reveals the growing importance of Medicaid expansion for rural Kentucky.

Nine of the top 10 rural counties for Medicaid enrollment nationwide are in Kentucky, according to research from the University of North Carolina Sheps Center for Health Services Research and the Georgetown University Center for Children and Families. Executive Director Joan Alker at Georgetown said these are economically challenged counties in the southeast corner of the state, where nearly half of adults rely on Medicaid coverage.

About 95,000 Kentuckians are expected to lose Medicaid coverage under the state’s new waiver.(Photo by jamiesue/Twenty20 via PNS)

“Because these rural counties do have high poverty rates, this is Medicaid expansion working to really support not only those folks on Medicaid, but the healthcare infrastructure in those counties, including the rural hospitals,” Alker said.

Alker said Kentucky’s pending Medicaid waiver would result in considerable coverage losses, with ripple effects throughout these counties. The waiver includes work requirements and provisions that could threaten the ongoing coverage of eligible people.

As Chief Medical Officer at Grace Community Health Center in Manchester, Dr. Kelly Evans explained Medicaid expansion has brought down the uninsured rate and helped boost healthcare infrastructure in the area.

“We have the outreach workers that are helping people to get signed up for insurance. And we’ve been able to add providers in order to service the increase in patients,” Evans said. “That adds jobs to the area and it provides greater access for the patients to have care.”

Evans said she’s concerned the waiver will create too much red tape and discourage people from applying for coverage. She explained they could miss out on regular medical visits and medications to keep them healthy.

“Even for people who don’t have a chronic illness, seeing a doctor for regular care and preventative measures – colorectal cancer screening when you reach age 50, your mammograms, getting regular eye visits and dental care – can prevent disease down the road,” she said.

According to state data, 95,000 Kentuckians would lose coverage under the waiver, which supporters argue is needed to save money and keep the Medicaid program sustainable. Economic policy experts counter that Medicaid expansion is an investment that has paid off for Kentucky through job growth, improved health, and a decrease in uncompensated care. They also note that fears of a budget shortfall are unfounded.

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