Nearly 100,000 Kentuckians are no longer getting health insurance through Medicaid and the public marketplace compared to a year ago—and that figure is only expected to get worse as Republican-backed state and federal Medicaid cuts take hold.
A new report from national healthcare advocacy group Protect Our Care found Kentucky’s enrollment in Medicaid, CHIP, and ACA health plans has dropped about 6.4% since last June—right before Trump’s “big, beautiful” bill was signed into law, and months before Republicans let ACA subsidies expire, causing health insurance premiums to spike.
Since then, Kentucky’s Republican-dominated state legislature also passed a state budget that shorted state Medicaid funds and put in place more strict Medicaid work requirements than federally required.
Dustin Pugel, a policy expert with KyPolicy, said it’s true that enrollment figures have fallen in Kentucky over the last year, but it’s too early to fully point the finger at federal or state Medicaid cuts.
“The worst of the enrollment losses are yet to come,” Pugel told Hellbender Newsroom.
Some immigrants quickly lost health coverage once HR 1 passed last year, and many Kentuckians dropped their ACA coverage after seeing how much their premiums would be once subsidies expired about six months ago, Pugel said.
Thousands of Kentuckians will likely lose health insurance in the coming months as more federal and state changes go into effect, he noted. But just how many Kentuckians could lose coverage is unclear. An estimate from the state signaled about 28,000 Kentuckians could lose insurance, while Pugel said some national estimates he’s seen put the potential Kentucky figure at closer to 100,000 to 200,000.
When people drop Medicaid or ACA coverage, it is hard to know for sure where they access alternative care. Some may be dropping off the list because they’re now old enough to qualify for Medicare. A majority become uninsured, Pugel said, including people with low-wage jobs that don’t offer health plans as well as immigrants and refugees.
Starting in January, some Kentuckians will face tougher standards to qualify for and keep health insurance. Kentucky’s Republican-led legislature instituted higher thresholds than what the feds required, requiring certain Kentuckians trying to stay on Medicaid to prove they’ve met certain work requirements three months out of the last six. Federal law requires just one month.
They’ll also have to prove that they’re eligible for Medicaid more frequently—a move Pugel worries could cause Kentuckians to lose healthcare over increased procedural issues like missing paperwork.
