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Tuesday, October 22, 2013

Kentucky Health Exchange Shines As Federal Site Stumbles

Screenshot from Kentucky's health exchange website, kyenroll.ky.gov

Screenshot from Kentucky’s health exchange website, kyenroll.ky.gov

Kentucky’s state-run exchange Kynect has succeeded in enrolling more than 15,000 people in health insurance since it began running Oct. 1. Kentucky is one of 17 states that runs its own marketplace for uninsured people to shop for coverage.

Kentucky’s exchange ran into a few technical problems on its opening day, but state tech workers quickly added new servers and solved the problems.

The state had outsourced the design of its exchange to the same contractor, CGI Group of Canada, that is facing blame for the technical problems with the rollout of the federal exchanges.

Kentucky Governor Steve Beshear joins Here & Now’s Robin Young to discuss his state’s exchange.

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ROBIN YOUNG, HOST:

Well, we're learning more today about why there have been so many problems with the federal government health exchanges running in 36 states. Bloomberg News and the Washington Post both reporting today that test runs, beta tests, of the online insurance marketplaces were skipped in the rush to get the websites online by October 1.

USA Today is reporting that Verizon's Enterprise Solutions Division is part of the tech surge coming to the federal government's rescue. Meanwhile, some of the 17 states that are running their own state exchanges are seeing people apply and enroll as mandated by the Affordable Care Act. Kentucky is the only Southern state to both expand Medicaid and operate its own insurance exchange. The state's Democratic Governor Steven Beshear has been touting its success.

It's called Kynect, K-Y-N-E-C-T, KY as in Kentucky, and Governor Beshear joins us on the line. Governor, we've been hearing the numbers, 1,000 Kentuckians a day signing up?

GOVERNOR STEVEN BESHEAR: Yes, so far that's the rate that we see is about 1,000 per day. So far, Robin, we have had over 280,000 visitors to our website. They're just swarming all over our website. We've had about 66,000 calls on our hotline, over 47,000 applications for health care coverage have been started, and we're over 18,000 individuals now enrolled in either Medicaid or a new health insurance policy. So it's going great guns here in Kentucky.

YOUNG: Well, it wasn't exactly great guns on the very first day. You did have some technical glitches.

BESHEAR: We had a few technical glitches the first day, and we got them ironed out, and it's been smooth sailing ever since. And, you know, folks - to me what this shows, Robin, is that people are eager to find out for themselves the facts. You know, there's been this web of misinformation woven out here for months now by the critics of the Affordable Care Act, and nobody knew what the real facts were, and now they're finding out for themselves.

YOUNG: Well, you say web of information. Isn't that the Obama administration's fault that people really were uninformed about Obamacare? And not all of it is, you know, misinformation. This was disastrous - by all accounts, even the president's account, technical rollout. Shouldn't they have been more prepared?

BESHEAR: Well, certainly the website didn't work as it should've worked. But look, it's going to work. Whether it's next week or next month, they'll get it fixed. And you've got to put this in historical context. This is a process. It's like the Medicare Act when it passed. It took three or four years before every kink was ironed out and every bump in the road was straightened out. The web of misinformation I'm talking about is the one spun for months now by the critics putting out all kinds of misinformation about oh my gosh, it's going to throw everybody out of work, you know, don't go near this website, all of those kind of things.

And as people find out now what is offered and the fact that they can afford it, these critics eventually are going to end up with egg on their face.

YOUNG: Well, we'll get back to that, but why do you think your website is working so well? You used one of the same subcontractors that the federal government did, this is the CGI Group of Canada. So what did you do differently, perhaps?

BESHEAR: Well, first of all, our prime contractor was Deloitte, and they did a fantastic job. They picked their subs. But our folks at the Health Cabinet and the Medicaid Department were all intricately involved in designing this website, and they worked with the vendors. And we made it simple, we made it direct...

YOUNG: You allowed people to check for their eligibility for things like, you know, am I eligible for the expanded Medicaid. Your system allows people to check for eligibility without creating an account.

BESHEAR: That's right, and that made it much more simple to operate, and it works, it's working well. The other thing that obviously we have to keep in mind, we're dealing with 640,000 uninsured Kentuckians. We're not dealing with 40 million people. But I'm proud to say we're the gold standard in terms of state exchanges and how these things ought to work.

YOUNG: Well, let's talk more about why that is. People are crediting you with having these people, the staff familiar with working with Medicaid eligibility just hovering over the vendors so that they were - they were described as bleary-eyed, but so that they were involved 24/7. In the federal government, the criticism seems to be that the Department of Medicaid and Medicare Services just didn't seem to have the expertise. Is that something that needs to be looked at?

BESHEAR: I'm sure that they will figure out all the glitches. Here locally in Kentucky, the folks that were involved in this have been excited from the beginning. Why? Because we're changing the course of Kentucky's history here. We're going to be able for the very first time to offer every single Kentuckian access to affordable health care coverage. And that's going to be a huge sea change for us.

In a generation, we're going to have such a healthier workforce that we'll be able to attract more jobs, more businesses...

YOUNG: You've got 640,000 people to go. At 1,000 a day, do you think you're going to get enough people enrolled to sustain the project? And further, do you worry if it starts to collapse on the federal level, are you and your people in Kentucky left holding a little bit of a bag? Will their premiums shoot way up if there's not enough people in the larger pool to support the system?

BESHEAR: First of all, it's not going to collapse on the federal level because the president is not going to allow it to. It's going to work. You know, I know it's got all these problems, but you just watch. It will work. It'll take some time. Here in Kentucky, yes, we're signing them up at the rate of 1,000 a day. I mean, that's amazing to us. We didn't expect that kind of initial input here.

And it'll take us months, if not two or three or four years, to find all 640,000 of these folks, but it - we will find them. And hopefully we'll get virtually every one of them involved because people are hungry for this. They really want affordable health coverage, and by golly, we're going to get it for them.

YOUNG: You mentioned how much more the federal government has to cover than you do as a state, and that's in part because many states rejected Obamacare and did not start their own exchanges. What would you message be to other governors who have put some of that pressure on the federal government? What would your message be to them?

BESHEAR: Well, my message to these governors that didn't set up their own exchange but also haven't expanded their Medicaid program is simply this: You're missing the boat, and you're putting politics before the interest of your people. You know, it's going to create 17,000 new jobs over the next eight years. So it's a win-win situation for us here in Kentucky.

And I predict to you, Robin, that down the road, sooner or later, every one of these states are going to have to step up and get involved in these programs because their people are going to demand it.

YOUNG: We'll see you again down the road, how's that?

BESHEAR: Thank you, Robin.

YOUNG: Steven Beshear, governor of Kentucky, thanks so much.

BESHEAR: You're welcome.

JEREMY HOBSON, HOST:

And Robin, while we are talking about health care in this country, there is a health scare going on in China because of air pollution. Have you seen these photos?

YOUNG: Well, you can barely see the photos.

HOBSON: From this city, this city in northeastern China that had to basically shut down because of pollution. The level of fine particulate matter in the air reached 1,000 micrograms per cubic meter. It doesn't mean much to you or me, perhaps, but it's 50 times what is considered safe.

YOUNG: It looks like they're living in like a fog.

HOBSON: It does. You can only see a few yards ahead of you. They're going to have the details about what kind of new regulations might be aimed at cutting pollution like that later on ALL THINGS CONSIDERED. Transcript provided by NPR, Copyright NPR.


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Robin Young and Jeremy Hobson host Here & Now, a live two-hour production of NPR and WBUR Boston.

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