Senate OKs bills to give assembly say on Medicaid

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Associated Press

Posted on February 23, 2013 at 6:01 PM

FRANKFORT, Ky. (AP) — The Senate approved two bills Friday that would give the Legislature more say on the federal health care overhaul's role in Kentucky.

The measures would allow lawmakers to vote on whether Kentucky expands the Medicaid program and sets up a state-run marketplace to sell insurance to individuals and small businesses.

Both actions are currently at the discretion of Democratic Gov. Steve Beshear. He already green-lighted the insurance exchange but hasn't decided on expanding Medicaid, a federal-state program that helps pay for health care for some people who are poor or disabled.

The votes were along party lines in the Republican-controlled chamber. The bills are expected to die in the Democratic-led House.

Republican senators insisted the bills were not referendums on Medicaid expansion or the exchange. Instead, they said the health care law's impact in Kentucky, particularly its potential costs, deserves input from the General Assembly.

Democrats contended the bills were attempts to block implementation of the health care law, which Republicans have criticized. Democrats said federal funding for Medicaid expansion could save the state money while providing coverage to an additional 300,000 residents.

Discussion on the bills focused almost entirely on Medicaid. The program covered about 825,000 Kentuckians in fiscal year 2012, according to the state's Cabinet for Health and Family Services.

Under expansion, Medicaid would cover anyone who is younger than 65 years old and earns up to 138 percent of the federal poverty line, or about $15,400 for an individual.

States and the federal government share Medicaid's costs. Kentucky typically pays about 30 percent, according to the Kaiser Family Foundation. For states that expand Medicaid, the federal government said it will pick up the full cost of the additional enrollees for the first three years and 90 percent of the cost after that.

"There is not a question being posed as to whether or not to expand Medicaid," said Sen. President Robert Stivers, R-Manchester. "It is just that it should be a legislative-driven decision versus an executive branch decision."

But discussion at times focused on whether Kentucky should expand the program. Republicans were skeptical of the idea, if not opposed to it.

"What has happened to us on many occasions (was) the opportunity to see programs ramped up when there is a (federal) match," Stivers said. "And then after we get it started, the federal government pulls their participation, and we're caught picking up all the costs."

Democrats said Kentucky could abandon expansion after the three years of full federal assistance.

"If we don't like it after that, we can walk away," said Sen. R.J. Palmer, D-Winchester.

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The legislation is Senate Bill 39 and Senate Bill 40.

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