Next Kentucky governor will determine state’s Obamacare future

Kentucky residents on Tuesday will choose their next governor, who will determine whether to continue Medicaid expansion in the state under the Affordable Care Act.

Recent polls show Democratic candidate Jack Conway, the state’s attorney general, has a slight edge over Republican Matt Bevin, who has vowed to modify the expansion instituted by outgoing Democratic Gov. Steve Beshear.

Bevin has said he would seek a waiver to alter the program and possibly implement one like Indiana’s, in which beneficiaries pay premiums for more coverage. He also said he would abolish Kynect, the state’s health insurance exchange. Conway has said he would keep the current Medicaid expansion model and continue Kynect.

Kentucky, which is ranked 47th among the states for overall health, has seen its uninsured numbers drop under the ACA more than almost any other state. The uninsured rate declined from more than 20% in December 2013 to about 9% this June, according to the Gallup Organization. Kentucky was one of the only southern states to fully implement the ACA, mostly because of Beshear’s actions.

The state’s coverage efforts received another blow earlier this month, however, when its co-op, Kentucky Health Cooperative, announced it would close up shop by the end of the year.