- Associated Press - Wednesday, December 2, 2015

MAYSVILLE, Ky. (AP) - Republican leaders of Kentucky’s state Senate said Wednesday they will not block about $250 million in state spending needed to pay for the health insurance of more than 400,000 people on the state’s expanded Medicaid program.

Outgoing Democratic Gov. Steve Beshear used an executive order to expand Kentucky’s Medicaid program under the federal Affordable Care Act. Because the federal government paid for 100 percent of the first three years of the expansion, Beshear did not need to ask the state legislature for money to pay for it. But Senate Republicans, fearful of the eventual cost of the program, tried and failed at the time to prevent Beshear’s actions.

Last month, Kentucky voters overwhelmingly elected Republican Matt Bevin as their next governor. Bevin campaigned on repealing the Medicaid expansion and replacing it with something else. He has called his 9-percentage point victory a mandate to enact his policies.

Kentucky must start paying for a portion of the Medicaid expansion beginning in January 2017. Republican Senate President Robert Stivers said it will cost Kentucky about $250 million over the next two budget years. When state lawmakers return to Frankfort in January, they will have to vote on a two-year state spending plan that would include that money - giving Republicans an opportunity to block the spending. But Stivers, speaking to reporters at the start of a two-day Republican caucus retreat in Maysville, said the Senate does not plan to do that.

“Just as Gov. Beshear implemented by executive order, Gov. Bevin can deal by executive order. It’s appropriate to see what direction he wants to go,” Stivers said. “I think you saw this from Gov. Bevin during the campaign as he became more familiar with the issues saying, ‘We want to transition, not to just totally stop it.’”

Any changes Bevin makes to the Medicaid program will be slow. He has said he wants to apply to the federal government for a waiver allowing the state to make significant changes to the program, including requiring people to pay a small premium and limiting who can participate in the program. Those changes could mean some people who qualify for health insurance now could lose their eligibility under a new system.

Bevin takes office Dec. 8. He has not yet given details of his Medicaid plan or appointed a secretary for the Health and Family Services Cabinet that oversees the program. If he is successful, Kentucky would become the first state to repeal the Medicaid expansion.

A repeal would continue Kentucky’s slow transformation into a Republican state. Republicans now control both U.S. Senate seats and all but one of the state’s congressional seats. They have a super majority in the state Senate and control four of the six statewide constitutional offices. But Democrats still have a seven-seat majority in the state House of Representatives, the last legislative chamber in the South still in Democratic control.

Wednesday, Kentucky’s Senate Republican leaders outlined an aggressive agenda designed to pressure House Democrats to take tough votes in an election year, including bills to ban mandatory union membership, repeal the prevailing wage law for government contractors and require women seeking an abortion to have an ultrasound first.

“We’re going to pass a lot of bills that have wide support in Kentucky, and we know we have a governor there that will sign them,” Senate Majority Floor Leader Damon Thayer said. “And the House will have the choice of, you know, deal with them or not. And they make decisions on policy at their own peril.”

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