Kentucky's ACA rollout is a reminder of what can happen when the law isn't being sabotaged, by @DavidOAtkins

Kentucky's ACA rollout is a reminder of what can happen when the law isn't being sabotaged

by David Atkins

Yesterday I posted how Republicans were hurting business, the poor and the middle class by sabotaging Obamacare. Meanwhile, here's a story of what can happen even in a hard-hit red state that isn't directly sabotaging the program:

Now it was the beginning of another day, and a man Lively would list as Client 375 sat across from her in her office at a health clinic next to a Hardee’s.

“So, is that Breathitt County?” she asked Woodrow Wilson Noble as she tapped his information into a laptop Thursday morning.

“Yeah, we live on this side of the hill,” said Noble, whose family farm had gone under, who lived on food stamps and what his mother could spare, and who was about to hear whether he would have health insurance for the first time in his 60-year-old life.

This is how things are going in Kentucky: As conservatives argued that the new health-care law will wreck the economy, as liberals argued it will save billions, as many Americans raged at losing old health plans and some analysts warned that a disproportionate influx of the sick and the poor could wreck the new health-care model, Lively was telling Noble something he did not expect to hear.

“All right,” she said. “We’ve got you eligible for Medicaid.”

Places such as Breathitt County, in the Appalachian foothills of eastern Kentucky, are driving the state’s relatively high enrollment figures, which are helping to drive national enrollment figures as the federal health exchange has floundered. In a state where 15 percent of the population, about 640,000 people, are uninsured, 56,422 have signed up for new health-care coverage, with 45,622 of them enrolled in Medicaid and the rest in private health plans, according to figures released by the governor’s office Friday.

If the health-care law is having a troubled rollout across the country, Kentucky — and Breathitt County in particular — shows what can happen in a place where things are working as the law’s supporters envisioned.

One reason is that the state set up its own health-insurance exchange, sidestepping the troubled federal one. Also, Gov. Steve Beshear (D) is the only Southern governor to sign on to expanded eligibility parameters for Medicaid, the federal health-insurance program for the poor. The less technical reasons involve what Lively told Noble next.
Obamacare is an inefficient public-private kludge; Single-payer would be better. But the ACA is still pretty decent, all things considered, when it's not being sabotaged. It's making a real difference in the lives of these folks in Kentucky.

How long, one wonders, can Republicans continue to openly screw over even their own white Southern base before people start to realize the truth?