- Associated Press - Monday, February 23, 2015

SHELBYVILLE, Ky. (AP) - Republican candidate for governor Matt Bevin said he would undo the expansion of the state’s Medicaid system, a move that would take away health insurance from nearly 400,000 people.

Bevin is the first candidate to promise this, ensuring the Affordable Care Act will play a prominent role as four Republicans try to woo the state’s conservative voters ahead of the May 19th primary.

“Absolutely. No question about it. I would reverse that immediately,” Bevin told reporters during a news conference in Shelbyville with his nine children standing behind him. “The fact that we have one out of four people in this state on Medicaid is unsustainable, it’s unaffordable and we need to create jobs in this state, not more government programs to cover people.”

The federal Affordable Care Act required states to expand their Medicaid programs to cover anyone who earns up to 138 percent of the federal poverty level, or about $33,900 annually for a family of four. The U.S. Supreme Court later ruled states did not have to expand Medicaid, but they could if they wanted to.

In Kentucky, Democratic Gov. Steve Beshear chose to expand Medicaid. And because the federal government promised to pay for 100 percent of the new enrollees for the first three years, he did not have to have the state legislature’s permission. State health officials expected about 150,000 people would enroll in the first year. Instead, the state enrolled more than twice that many.

Republicans have criticized Beshear’s decision, pointing out the state would have to start paying for those people eventually and arguing taxpayers could not afford it. The state has struggled through the economic recession, ending the most recent fiscal year with a $91 million shortfall.

But earlier this month, Beshear touted the results of a $140,000 study that showed the federal government spent $1.2 billion in Kentucky last year to pay for the new enrollees. That massive jolt to the state’s health care industry created 12,000 new jobs and generated an additional $37.4 million in state tax revenue. The study projects that over eight years, the state’s net savings and new revenue from the Medicaid expansion will be $819 million.

“What are you going to replace it with? How are these 500,000 people going to have affordable health care if you shut this program out?” Beshear asked when announcing the study.

“It’s nonsense,” Bevin said. “If in fact putting one out of four people in the state of Kentucky on Medicaid created 12,000 jobs and $30 billion in economic prosperity, why wouldn’t we put every single person in the state of Kentucky on Medicaid? We’d create 48,000 jobs by that logic and $120 billion worth of economic advantage.”

The Affordable Care Act is fraught with political peril for Republican candidates in Kentucky because of the law’s association with Democratic President Barack Obama. Polls show close to 60 percent of state voters disapprove of Obama, so much that Republican U.S. Sen. Mitch McConnell was re-elected by 15 percentage points following a campaign built on opposing the president’s agenda.

But eliminating the Medicaid expansion is also risky, because it would take away the health insurance from so many people and allow Democrats to portray Republicans as uncaring. The other Republican candidates for governor - James Comer, Hal Heiner and Will T. Scott - have said they would eliminate the state-run marketplace where people can purchase subsidized health insurance but have not said they would undo the state’s Medicaid expansion.

“You can’t roll back the Medicaid expansion because it’s already there,” Scott, a former Kentucky Supreme Court justice, said before a speech to the Kentucky Association of Realtors on Feb. 3.

Comer, the state agriculture commissioner, said he would work to decrease the state’s Medicaid population by creating an environment “to get people out of poverty to get off Medicaid.” But he acknowledged that eliminating the expansion would be difficult because it will have been in place for two years by the time the next governor takes office.

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