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State Senator Seeks Answers to Health Care Reform Questions

Vice chair of Health and Welfare Committee knows what is at stake

As vice chair of the Kentucky legislature’s Health and Welfare Committee, State Senator David Givens (R-Greensburg) has been keeping an eye on health care reform and pondering its repercussions for Kentucky. There are many unanswered questions connected with the health care reform act, Givens said.

“The question Kentucky faces as a state is, ‘What are the costs of a potential expansion of the Medicaid rolls?” he said.

At present, approximately 21 percent of Kentucky’s population receives Medicaid. Expanding the program could add almost 400,000 people to the rolls. “That would put a quarter of the population on Medicaid,” Givens said. “That would result in a cost that could be unsustainable in the face of other demands such as education, social services and pensions.”

Givens said Kentucky has already utilized $67 million of federal money to put in the infrastructure that was mandated at the direction of Gov. Steve Beshear. This included software and technology and servers for electronic record keeping. An unknown dollar amount in additional federal grant money is being sought to implement the exchanges. Givens said the legislators were told the ongoing cost to run the exchanges would be paid by a fee levied on those insurance providers that were part of the exchange, but that only raised more questions.

“The cabinet had no knowledge of what that cost would be and whether or not the rate of adoption by the insurance community would be sufficient to meet the cost,” he said. “That’s just one example of the many unanswered questions before us.”

Givens believes the state legislature has not been given a chance to participate in the discussion. Inevitably, he said, that will be necessary. “It may require expanded taxation authority that the administration does not have to date,” Givens said. “So far everything has been done by executive order. Anything done by an executive order can be undone by the next governor by executive order.”

Because he serves six counties in South Central Kentucky, Givens is particularly interested in the accessibility of health care in rural areas. “This is such a broad piece of legislation that totally changes the landscape of health care delivery,” Givens said. “We often talk about the unintended consequences, but even the intended consequences of this legislation are still to be determined.”

Additional costs may arise as well. “I’m expecting us to incur directly $300 million to $400 million of additional annual costs,” Givens said.

Givens senses some discontent about the reforms in the medical community. “There is a lot of disappointment in the medical community about the chaos around the implication of Medicaid managed care,” he said. “The process that we’ve gone through has created considerable ill feeling in the medical community, and that implementation was also done with no input from the General Assembly.”

Citing the many unanswered questions, Givens leans towards advocating a “wait-and-see” approach, although he adds, “We’ve got two more years before the next gubernatorial election and I don’t know if we can wait that long.”

He believes voters need to keep an eye on what is happening and speak up when necessary. “I always urge citizens in our state to be connected to their legislators and make sure their voices are being heard,” he said.

By Tanya J. Tyler, Associate Editor



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