There’s A Huge Demand For Obamacare Coverage In Rural Kentucky


So far, the open enrollment period for Obamacare’s state-level insurance exchanges has been plagued with technological problems, and the federal website continues to struggle. But there are a few states where the process is operating relatively smoothly. Kentucky, which had led the nation in enrollment numbers, is one of those unlikely success stories.

The Bluegrass State is the only southern state that has implemented both of the major provisions of the health reform law, choosing to expand its Medicaid program and set up its own state-level exchange. It also poured $11 million into a public education campaign to educate Kentucky residents about Obamacare. That’s paid off, and enrollment has surged.

That’s partly because of the sheer number of people in the state who stand to benefit from the health reform law. Obamacare’s expansion of the Medicaid program is projected to cut Kentucky’s uninsurance rate by more than half. And, as the Washington Post reports, the ongoing political fight over health reform doesn’t matter too much to those uninsured people — many of whom are gaining coverage for the first time in years.

The news about Obamacare is spreading rapidly by word of mouth. Courtney Lively, who has been working to enroll people in one of Kentucky’s poorest counties, told the Washington Post that people are “pouring in” to her office.


Lively is working with people who live in Breathitt County, KY, where the average per-capita income hovers around $15,000. The region is nicknamed the “Coronary Valley” because of its extremely high rates of diabetes and hypertension. Lively explained that although she often refrains from using the word “Obamacare,” it doesn’t take much persuading to get Breathitt residents to enroll in public insurance. Many of them haven’t visited the doctor in years. Some of them start crying when they learn they’re eligible for Medicaid. Then they go home and tell their relatives to visit Lively, too.

More than 56,000 people in Kentucky have signed up for coverage under Obamacare. And the majority of those people are gaining public insurance under the expanded Medicaid program.

Kentucky Gov. Steve Beshear (D) anticipated this dynamic. He’s indicated that he knows exactly how much his state needs Obamacare. Back in September, Beshear published a New York Times op-ed arguing that the health reform law represents a “historic change” for red states with high rates of uninsurance. “Frankly, we can’t implement the Affordable Care Act fast enough,” the governor wrote. “Here in Kentucky, we cannot afford to waste another day or another life.”

Other states have had similar success stories with their own Medicaid programs. For instance, Oregon enrolled so many low-income people in Medicaid that it cut its uninsurance rate by ten percent in just the first two weeks. More than 50,000 people have enrolled in Medicaid in West Virginia, and more than 60,000 have initiated the process in Arkansas.

But not every state is achieving those types of numbers. A political fight over Obamacare has led many Republican lawmakers to draw battle lines at their public insurance programs. Twenty five states have declined to expand their Medicaid pools, leaving millions of poor Americans without any access to affordable insurance at all.