- Associated Press - Thursday, December 3, 2015

FRANKFORT, Ky. (AP) - Republican Gov.-elect Matt Bevin has chosen a Louisville attorney to lead his efforts to dismantle and replace the health care system put in place by his Democratic predecessor.

Vickie Yates Brown Glisson will be the next secretary of the Health and Family Services Cabinet, Bevin announced Thursday. The agency operates the state’s Medicaid program, which outgoing Democratic Gov. Steve Beshear greatly expanded under the federal Affordable Care Act.

The expansion means another 400,000 people have government-funded health insurance, cutting the state’s uninsured rate in half and garnering praise from health care advocates across the country. But it also has strained Kentucky’s finances, adding an estimated $250 million in costs to the next two budget years in a state already grappling with billions of dollars of unfunded liabilities in its public pension systems.

“The appointment of the Secretary of the Cabinet for Health and Family Services is one of the most critical decisions I will make as Governor,” Bevin said in a news release. “We have 1 in 4 of our citizens enrolled in Medicaid and the financial costs to the Commonwealth are growing exponentially. We must be innovative in our efforts to improve health outcomes for Kentuckians, but do so in a prudent and sustainable manner.”

Glisson is a health insurance attorney at the Louisville law firm of Frost Brown Todd. She is the past chairwoman of the health law section of the American Bar Association. She has served on the advisory council for both the Human Genome Project and the National Institute of Diabetes, Digestion and Kidney Disease as part of the National Institutes of Health.

“She’s very well-respected in legal circles in terms of health policy,” said Michael Rust, president of the Kentucky Hospital Association. “It’s a major appointment. One of the toughest jobs in state government is running that cabinet.”

Glisson’s first task will be to eliminate kynect, the health insurance exchange state officials set up with the help of $283 million in federal grants. More than 100,000 people have purchased private health insurance plans on the exchange with the help of federal subsidies. Bevin has promised to eliminate the program, saying people can purchase the same plans from the federal exchange.

Beshear has estimated it will take at least nine months and cost at least $23 million to dismantle kynect and transition people over to the federal exchange. But Bevin says it will save money by eliminating the exchange’s annual $28 million budget, paid for by a 1 percent tax on all health insurance premiums.

And Glisson will likely lead Bevin’s plan to reform the state’s Medicaid program. Bevin has said he wants to limit the program’s eligibility but has not how he plans to do that. Whatever he does will be watched closely by the health care industry as Kentucky could become the first state to repeal an expansion of its Medicaid program since the federal Affordable Care Act was passed in 2010.

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