FRANKFORT, Ky. (AP) -- Kentucky's Medicaid program will expand to cover an additional 300,000 people, most of them the working poor who don't now have insurance coverage, Gov. Steve Beshear said Thursday.
A smiling Beshear announced his decision to applause from proponents gathered in the ornate State Reception Room on the second floor of the Capitol. It's a venue typically reserved for major announcements. The second-term Democrat had run for governor on the promise that he would work to provide medical coverage to Kentucky's 640,000 uninsured residents.
"The bottom line is it's the right thing to do," Beshear said.
Beshear said he made the decision after completing research that found Kentucky will benefit in terms of health and financial outcomes by expanding Medicaid coverage.
"In fact, if we don't expand Medicaid, we will lose money," he said.
The government health care program already provides medical coverage to some 800,000 residents. Under the Affordable Care Act, Kentucky had the option of expanding coverage to some 308,000 additional people with incomes up to 138 percent of the federal poverty level. That means individuals making up to $15,860 a year would be eligible as would a family of four making up to $32,499.
Washington will pick up the entire cost of the expansion for the first three years, and 90 percent over the longer haul.
Beshear's announcement drew praise and criticism.
"Despite decades of hard work, too many Kentuckians are one illness or one accident away from financial ruin because they lack access to affordable, adequate health care coverage," said Cathy Allgood Murphy, a lobbyist for AARP Kentucky. "By accepting federal funds for health care expansion, Kentucky can make a real difference in the lives of thousands of people."
U.S. Senate Republican Leader Mitch McConnell said Beshear has exposed taxpayers to "open-ended expenses" by expanding the Medicaid program.
"Given Kentucky's struggles to finance its current Medicaid program and the uncertainty of future federal funding, I am surprised the governor would make this decision to further implement Obamacare and expose the commonwealth's taxpayers to more open ended expenses they cannot afford," he said in a statement. "Additionally, in my travels across Kentucky I have talked to a number of health care professionals who are concerned that a dramatic expansion of Medicaid enrollment would obviously exacerbate the already serious access-to-care problems we face in Kentucky."
Nationally, about 15 million people — mostly adults with no children living at home — could eventually be covered if all states expand. But the Supreme Court last year gave states the right to reject the expansion without jeopardizing the rest of their federal Medicaid funds.
Expanded Medicaid will be available starting Jan. 1, and uninsured people can start signing up this fall. So far, 21 states plus Washington, D.C., have accepted the expansion, while 14 states have turned it down. Another 15 states are still weighing options.
Nearly all the states refusing are led by Republicans. Several of the states accepting have Republican governors, but most are led by Democrats.
Beshear said a review by the University of Louisville and the accounting firm Price Waterhouse Coopers found that expanding Medicaid will create nearly 17,000 jobs in Kentucky and have a $15.6 billion positive economic impact between 2014 and 2021. He said the review also found that expanding Medicaid would have an $800 million positive impact on the state budget over the same period.
Beshear said his decision was to do what's best for Kentuckians, despite criticism from opponents.
"The question really shouldn't be: Can we afford to expand Medicaid?" he said. "The question should be: Can we afford not to?"
Republican state lawmakers weren't convinced. House Republican Leader Jeff Hoover of Jamestown said Beshear's decision threatens the financial stability of the state.
"My initial reaction is it appears the General Assembly will have two options in the near future: cut spending even further, or raise taxes," Hoover said. "I can assure you that I do not intend to raise taxes."