Battle could be ahead for Ky. health reforms

FRANKFORT, Ky. (AP) -- Democrats and Republicans in Kentucky's Legislature are primed for a lively debate on federal health care changes that could provide Medicaid benefits to some 400,000 additional Kentuckians and create an insurance exchange that would make it easier for people to find affordable private coverage.

House Speaker Greg Stumbo, D-Prestonsburg, said Wednesday that he will oppose legislation that could impede implementation of two key parts of the Affordable Care Act, the federal initiative that he touts as a way to improve the health of Kentucky residents.

"Not only is it a good benefit to the state, it's also something that morally we should do," he said. "I think once the facts are on the table that members will have a very difficult time voting against it."

Stumbo told reporters he believes the state "would be ill-served" not to take full advantage of the health care changes that would expand Medicaid coverage to additional uninsured residents.

State Sen. Julie Denton, R-Louisville, introduced legislation Wednesday that would require Gov. Steve Beshear to get legislative approval before implementing the health insurance exchange or opening the state's Medicaid program to additional recipients.

Denton said her legislation simply involves the lawmakers in decisions about implementing costly changes. The operation of the health insurance exchanges alone, she said, could be some $40 million a year and that expanding the Medicaid rolls could add another $170 million a year.

By making that investment, Stumbo countered that Kentucky stands to receive some $2 billion a year from the federal government.

Beshear has already directed his administration to set up the health care exchange, which he said will be ready to operate by next January. He said he hasn't yet made a decision on whether to expand Medicaid rolls.

"What I'm doing right now is to try to gather all the information I can to determine whether, in the long run, we can afford to expand Medicaid," he said. "Obviously, if I determine we can afford to do it, I want to do it, because Kentucky is one of the most unhealthy states."

Tea party activists held a Capitol rally on Tuesday to call on Frankfort politicians to head off the health care changes at the state level.

"Medicaid is a budgetary disaster, and we need to stop doubling down on the failure, which is what the Medicaid expansion would do," said Lexington area tea party leader David Adams. "Senate Republicans should shut down everything in the General Assembly until we get this straight. It's that important."