The Best Obamacare Speech Obama Never Gave

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National Journal
Sophie Novack
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Sophie Novack
Oct. 3, 2013, 12:02 p.m.

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Ken­tucky Gov. Steve Be­s­hear, a Demo­crat from a red state, has a simple mes­sage for mem­bers of Con­gress try­ing to get rid of the Af­ford­able Care Act: “Get over it. And get out of the way so I can help my people.”

On day three of the gov­ern­ment shut­down over the health care law, Be­s­hear said he was per­son­ally of­fen­ded by the par­tis­an games­man­ship go­ing on in Wash­ing­ton and de­livered a speech in de­fense of Obama­care worthy of the pres­id­ent him­self.

“[Law­makers] are pour­ing time and money in­to de­fund­ing [the ACA],” he said in a speech and sub­sequent in­ter­view at Na­tion­al Journ­al‘s Count­down to Trans­form­a­tion event Thursday. “It is shame­ful they haven’t in­ves­ted the same time and money in­to try­ing to im­prove health of cit­izens. We need lead­ers who are fo­cused on help­ing people, not gain­ing polit­ic­al power.”

Ken­tucky is a unique ex­ample of a red state ag­gress­ively im­ple­ment­ing Obama’s sig­na­ture health care law. Mitt Rom­ney won more than 60 per­cent of the vote in the state in 2012, and it is con­sidered firmly con­ser­vat­ive. Yet Ken­tucky is the only South­ern state im­ple­ment­ing Medi­caid ex­pan­sion and op­er­at­ing its own state-based ex­change un­der the Af­ford­able Care Act.

Judging by the state’s suc­cess thus far, Ken­tucky could be a key test case for how the law works when fully and en­thu­si­ast­ic­ally im­ple­men­ted as in­ten­ded.

The Ken­tucky Le­gis­lature is split, with a Re­pub­lic­an Sen­ate and Demo­crat­ic House. Be­s­hear is­sued an ex­ec­ut­ive or­der set­ting up the state-based ex­change, an im­ple­ment­a­tion pro­cess dif­fer­ent from those in oth­er states. But Be­s­hear feels strongly about the im­port­ance of the ACA, both for Ken­tucki­ans’ health and qual­ity of life and for busi­ness and eco­nomy of the state.

“Those who say it’s a train wreck, they’re on their own train,” Be­s­hear said. “Be­cause so far, this thing is a huge suc­cess.”

(Kris­tof­fer Tripp­laar)

Cur­rently more than 600,000 people in Ken­tucky — or al­most one in six — are un­in­sured. The law will en­able all of these in­di­vidu­als to re­ceive cov­er­age; 308,000 will be eli­gible for Medi­caid with ex­pan­sion, and the oth­er 332,000 will be able to pur­chase cov­er­age on the ex­changes.

To de­term­ine wheth­er Medi­caid ex­pan­sion was fisc­ally wise for Ken­tucky, Be­s­hear con­trac­ted Price­wa­ter­house­Coopers and the Urb­an Stud­ies In­sti­tute at the Uni­versity of Louis­ville to run the num­bers.

“It took six months,” Be­s­hear said. “They came back and said, Gov­ernor, you can­not af­ford not to do this.”

The groups found that Medi­caid ex­pan­sion would add $15.6 bil­lion in­to the Ken­tucky eco­nomy over the next eight years, cre­ate al­most 17,000 jobs, and pro­tect hos­pit­als from fund­ing cuts.

Ken­tucky began the edu­ca­tion pro­cess about the law months ago, with people help­ing to pro­mote the law at col­lege cam­puses and fairs.

Like the fed­er­al ex­changes and oth­er state ex­changes, the Ken­tucky on­line mar­ket­place ex­per­i­enced its share of glitches. But while oth­ers — the fed­er­al ex­change in par­tic­u­lar — hit ma­jor snags pre­vent­ing people from en­rolling, the Ken­tucky ex­change has already had clear suc­cess.

Ac­cord­ing to Be­s­hear, the Ken­tucky ex­change site got its first con­tact at 12:01 a.m. on Tues­day, the day the ex­changes opened. In the first 48 hours, more than 118,000 in­di­vidu­als vis­ited the site, more than 109,000 ap­plic­ants were pre­screened, more than 13,000 people began the ap­plic­a­tion pro­cess, and nearly 8,300 com­pleted an ap­plic­a­tion. In ad­di­tion, 122 small busi­nesses star­ted their ap­plic­a­tion pro­cess.

Be­s­hear said these num­bers speak for them­selves.

“In Ken­tucky, we can’t af­ford to waste an­oth­er day or an­oth­er life. You don’t have to like the pres­id­ent or like me, it’s not about the pres­id­ent or about me. It’s about you,” Be­s­hear said, adding, “I don’t care if it’s a Re­pub­lic­an idea or a Demo­crat­ic idea, as long as it’s a good idea.”

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