Rural areas saw greatest increase in access to healthcare under Medicaid Expansion, according to Indiana University study

Medicaid expansion under the Affordable Care Act greatly increased access to health care for Americans, especially in rural areas, says an Indiana University study published in The Journal of Rural Health.

Researchers, who used data from the Census Bureau’s American Community Survey from 2011-15, found that expansion “increased the probability of Medicaid coverage for targeted populations in rural and urban areas, with a significantly greater increase in rural areas, but some of these gains were offset by reductions in individual purchased insurance among rural populations,” according to a Kentucky Health News article.

Medicaid covered almost 636,000 adult Kentuckians in the second quarter of this year, with the great majority of enrollees covered under Medicaid expansion and almost half of them young adults, according to a report done for the Foundation for a Healthy Kentucky. The report found that 493,199, or 78 percent, of the 635,747 adults covered by Medicaid in Kentucky were covered by the Patient Protection and Affordable Care Act’s expansion of the program to those who earn up to 138 percent of the federal poverty level. The remaining 142,548 were covered by traditional Medicaid.

IU researchers found that Medicaid expansion increased the probability that low-income people would have health coverage, and it increased Medicaid coverage more in rural areas than in cities. There was some evidence that in rural areas, the expansion was accompanied by some shifting from individually purchased insurance to Medicaid.


Kentucky sees highest decrease in hospital stays among uninsured residents, study shows

hospital buildingStates that expanded eligibility for Medicaid in 2014 – such as Kentucky – experienced dramatic decreases in uninsured hospital stays and increases in Medicaid-covered stays, according to a new study by Health Affairs.

Kentucky saw the most dramatic change in uninsured hospitalizations among states that took part in the Medicaid expansion, seeing a drop of 13.5 percentage points. States that did not expand Medicaid saw very little change in inpatient payer mix.

“It’s really exactly what policy makers expected. In states that expanded Medicaid you see a pretty sharp uptick,” Sayeh S. Nikpay, PhD, MPH said in an article by Health Leaders Media. Dr. Nikpay was a research fellow at the University of Michigan Institute for Healthcare Policy and Innovation when she conducted the study. “It is nice when policies have their intended effect.”

The study found that between the third quarter of 2013 and the second quarter of 2014, “expansion states experienced a 7-percentage-point jump in the Medicaid share and a 6-percentage-point drop in the uninsured share.” The changes represent a 20% increase in Medicaid charges, and a 50% decrease in uninsured discharges.

For more information, please click here.


Kentucky leads way in drop of unpaid hospital stays since Medicaid expansion began

hospital buildingAccording to a study from the University of Michigan on the effects of Medicaid expansion, Kentucky hospitals were shown to have had the biggest drop in non-paying patients among 15 states.

Kentucky showed a decline of 13.5 percent in unpaid hospital stays in just the first six months after the 2014 expansion, according to the study. Hospitals in states that expanded Medicaid, like Kentucky, are taking care of more patients with health insurance, and thus have seen an increase in payments for their care, according to an analysis written by Melissa Patrick of Kentucky Health News.

Overall, hospital stays by uninsured patients went down 50 percent, and stays by people with Medicaid went up 20 percent, between the end of 2013 and the middle of 2014, a University of Michigan news release says. The study found that hospitals in states that did not expand Medicaid “continued to experience the same or even higher demand for care from people without insurance.”


Most Kentuckians want to keep Medicaid expansion in place, according to new poll

kaiser family foundation logoA new Kaiser Family Foundation poll of Kentucky residents finds that after much discussion of the issue, health care is the top issue residents want state lawmakers to address, and a strong majority opposes scaling back the state’s Medicaid expansion to cover fewer people as new Gov. Matt Bevin proposed during his campaign.

About seven in ten Kentuckians (72%) say they would prefer to keep the state’s Medicaid expansion as it is today rather than change it to cover fewer people. A much smaller share (20%) say they would prefer to scale back the expansion to cover fewer people.

Taken before Gov. Bevin’s inauguration last week, the poll finds that Kentucky Republicans are more divided about the Medicaid expansion, but a majority (54%) favors keeping it over changes that would reduce the number of people with coverage. Among those who say they voted for Gov. Bevin on Nov. 3, somewhat fewer (43%) support the Medicaid program as it exists, while half (50%) say they want it scaled back to cover fewer people.

“Kentuckians don’t particularly like the Affordable Care Act, but they do like their state’s Medicaid expansion and marketplace, and most want to keep them,” Foundation CEO and President Drew Altman said. “The findings in a red state may show other governors considering expansion that it could be equally popular with their state’s residents, and illustrate to Republicans in Washington how difficult it may be to take away health coverage from people who have it.”

The Kaiser Family Foundation is a non-profit organization focusing on national health issues, as well as the U.S. role in global health policy.  Unlike grant-making foundations, Kaiser develops and runs its own policy analysis, journalism and communications programs, sometimes in partnership with major news organizations. For more information, go online to

For more information about this poll, please click here. To read an article in the Lexington Herald Leader about the poll, please click here. To read an article in the Louisville Courier-Journal about it, please click here.


Latest quarterly report shows how many more Kentuckians have health insurance

foundation for a healthy KYThe State Health Access Data Assistance Center (SHADAC), a health policy research institute at the University of Minnesota, has been studying how the Affordable Care Act (ACA) has been impacting Kentuckians as part of a contract with The Foundation for a Healthy Kentucky.

The institute recently released its second quarterly health data snapshot, which covers the April-June 2015 timeframe. Highlights of this latest health data snapshot include:

  • From December 2013 to June 2015, Kentucky’s uninsurance rate dropped from 20.4% to 9.0%.
  • Medicaid funded thousands of preventive services during the quarter, including more than 10,000 breast cancer screenings. Over 9,000 of these breast cancer screenings were among Medicaid expansion enrollees, while nearly 1,200 were among traditional Medicaid enrollees.
  • Children obtained the majority of Medicaid’s dental visits, representing 66% of the more-than-250,000 dental visits provided during the quarter among Kentuckians under age 64.
  • Kentucky’s 11.4 percentage point drop in the rate of uninsured residents continued to outpace neighboring states (Illinois, Indiana, Missouri, Ohio, Tennessee, Virginia, and West Virginia), which averaged a 5.2 percentage point drop, as well as the national decline in uninsured, which was 5.7 percentage points.

Click here to view the complete 2nd quarterly health snapshot.

SHADAC is a health policy research center with a focus on state policy. For more information, go online to The Foundation for a Healthy Kentucky makes grants, invests in pilot projects, does research and polling, and informs policy discussions. It is committed to improving access to care, reducing health risks and disparities, and promoting health equity. For more information, go online to


Medicaid Expansion remains a pivotal issue in election for Kentucky Governor

image for votingThe two main candidates for governor – Republican Matt Bevin and Democrat Jack Conway – have differing ideas about what to do about the future of Medicaid Expansion, meaning that the election on November 3 could have serious and severe outcomes for more than 400,000 people around Kentucky.

Adam Beam of The Associated Press takes a closer look at the issue in his latest article from Frankfort. He reports that “twice as many people signed up in the first year as state officials had predicted, more than doubling the expansion’s estimated cost in 2017 from $33 million to $74 million. Those costs could swell to $363 million by 2021, further straining finances in a state wrestling with a multi-billion-dollar pension liability.”

He also mentioned other statistics, including:

  • Kentucky’s uninsured rate dropped from a high of 20.4 percent in 2013 to less than 10 percent last year
  • Hospitals covered less than $60 million of uncompensated care last year, down from $160 million in 2013
  • New Medicaid enrollees received more than 54,000 preventative screenings

According to the article, Conway “has said he would continue the Medicaid expansion unchanged” while Bevin “initially said he would reverse the expansion ‘immediately’ but has since clarified he would repeal the current expansion and replace it with something else.” Jessica Ditto, spokeswoman for Bevin, said in the article that Bevin’s plan “would not take away health insurance from 400,000 people, as Democrats say. She said some might be offered a new plan that would require them to pay ‘token amounts’ for a premium.”

To read more, please click here.


Legislative Leaders Discuss Future of Expanded Medicaid on KET Talk Show

KET LogoIn an episode of “Kentucky Tonight” that aired Aug. 24 on Kentucky Educational Television (KET), the state’s weekly issue-oriented discussion show, the General Assembly’s top leaders gathered to talk about healthcare, Medicaid expansion, and the 2015 gubernatorial election.

“The economy is good in Kentucky right now,” House Speaker Greg Stumbo, D-Prestonsburg, said on the show. “We can afford to provide (Expanded Medicaid), we can afford to continue to make sure that Kentuckians have it, we just have to monitor it and make sure we’re doing it efficiently.”

But raising concerns about the system’s sustainability was House Minority Leader Jeff Hoover, R-Jamestown, who said, “There are a lot of rural hospitals, particularly in my area and I think in other areas of the state, that are struggling financially now as much or more than any time in many, many years.”

To view the full episode on KET’s website, click here. To read a report on the conversation from Kentucky Health News, click here.



Quarterly Report Examines Impact of Affordable Care Act on Kentuckians

foundaThe Foundation for a Healthy Kentucky has contracted with State Health Access Data Assistance Center (SHADAC), a health policy research institute at the University of Minnesota, to study how the Affordable Care Act (ACA) is impacting Kentuckians, releasing their initial health data snapshot for the first quarter of 2015.

“Insurance coverage, access, cost of care and experience with Medicaid expansion and the state insurance exchange, kynect, are all among the issues SHADAC is tracking,” Susan Zepeda, President/CEO of Foundation for a Healthy Kentucky, said in a news release. “This multiyear study from a nationally known independent source will provide valuable data to inform health policy decisions.”

According to the report, for the first three months of 2015:

  • There were decreases in the number of uninsured and increases in public health insurance coverage among 18-64 year-olds both in Kentucky and the U.S.
  • Urban hospitals had more uncompensated care (hospital care for which no payment was received) compared to rural hospitals in Kentucky, but both levels dropped between 2013 and 2014.
  • Of all Kentuckians enrolled in Medicaid:
    • 32% live in Eastern Kentucky
    • 25% live in Western Kentucky
    • 19% live in Greater Louisville
    • 16% live in Greater Lexington
    • 8% live in Northern Kentucky
  • A total of 38,169 dental services were provided to Medicaid enrollees ages 19-64.
  • A total of 5,675 substance abuse treatment services were provided to traditional income-based and expansion enrollees ages 19-64.
  • A total of 4,586 hepatitis C screenings were provided to Medicaid enrollees ages 19-64.

For more information, go online to or follow them on Twitter @healthyky and @shadac.  And to see the Louisville Courier-Journal article about this, click here.


More Kentucky Residents on Medicaid Getting Preventive Health Services, Report Shows

kyhealthThe number of Kentuckians who received preventive health services has shot up since Medicaid expansion took effect in late 2013, says new data from the state Department of Medicaid Services (DMS) that was presented earlier this week during a meeting Wednesday of the oversight team for kyhealthnow, an initiative launched by Gov. Steve Beshear in early 2014.

In fact, “Kentuckians on Medicaid were far more likely to get cancer screenings, physicals and dental check-ups after the state expanded the government program for the poor and disabled through the Affordable Care Act,” according to an article in the Louisville Courier-Journal.

“I have said from day one that giving every Kentuckian access to affordable quality health care coverage will help us tackle our ongoing abysmal health outcomes,” Gov. Beshear said in a release. “We are now seeing our citizens take even greater advantage of the opportunity to receive these life-changing screenings for cancers like breast and colon. No longer are their medical choices limited to emergency room or charity medical visits. As these preventive health services increase so does the compensation to our medical providers who are helping to improve the wellness of our Kentucky families. I’m excited about the enormous gains we’re seeing and even more excited about the long-term implications for our state’s health.”

To read the 2015 kyhealthnow Annual Report, click here.


About 3 Million Uninsured Adults Have a Behavioral Health Condition, New Government Report Says

HiResAccording to a new report from the U.S. Government Accountability Office (GAO), about 3 million low-income, uninsured adults have a behavioral health condition, including serious mental illness, a substance use condition or both.

That number was divided evenly between states that did and did not expand their Medicaid programs.

The auditors said that the non-expansion states it studied offer treatment services for low-income uninsured people – though the programs prioritize care for people with the most serious illnesses. State officials in the Medicaid expansion states that GAO analyzed said they experienced an increase in availability of behavioral health treatment, though “some access concerns remain.”

The full report is available online here.