November 15th, 2014 marks the opening of enrollment for KYnect, the Kentucky created health insurance exchange. KYnect has made so many strides over the year since they first went into place. They have been a presence at local fairs and events throughout the state. They have shared information about the options, educating the public, and passing out reusable grocery bags so the citizens are aware. Here in Louisville, I’ve seen them at WorldFest and St. James Art Festival. They even opened a store in the Fayette Mall in Lexington, KY this week. Finally, there’s even a mobile app this year! These ways of improving their name recognition are not in vain.
As Governor Steve Beshear stated in his NY Times op-ed last year, Kentucky ranks highly in all the wrong things when it comes to health- smoking, obesity, heart disease, lung cancer, and diabetes. Through the efforts of our state with KYnect supported by Governor Beshear and outgoing Lieutenant Governor Abramson, our state has made amazing strides to improve the health care of its citizens.
Prior to the ACA going into effect last year, 20.4% of Kentuckians were uninsured. Gallup conducted a poll in August, and our uninsured rate dropped to 11.9%. We along with Arkansas had the largest drop in the country in terms of the uninsured.
Beyond the numbers, as I reflect on our patient population, I have seen a drastic difference. To give you an idea, last year, we were so accustomed to having uninsured patients at our downtown Louisville clinic, that we were experts at the Wal-Mart $4 formulary. We knew what inhalers were the cheapest to get our chronic lung disease patients. We knew how to titrate the complicated twice a day 70/30 insulin because that’s what our patients with diabetes could afford. We knew the resources and financial assistance available to hook our patients into the system to be able to just get that imaging or that colonoscopy that would help us provide a diagnosis.
This year, I can count on my hand the number of times I’ve referenced the Wal-Mart $4 formulary. Instead, we are focusing on referencing formularies to find the medications that will be covered on our patient’s insurance plan. The inhalers our patients struggled to afford are now covered by their formularies. The easy to take daily basal insulins which better regulate blood glucose and improve diabetes are readily available for our patients. The only hitch we encounter with imaging and other tests is a matter of finding a time that works for the patient to schedule it.
The Affordable Care Act has had a very positive impact on our state. Not everything is perfect, but this is the best start we have had in as long as I can remember. Rather than repealing the entire legislation, it would be better to fix portions that have been difficult to implement. But please, do not take away this opportunity for affordable healthcare that Kentuckians have access to. Our health depends on it. I hope our Senator recognizes and appreciates this positive impact for Kentuckians as we begin the enrollment process for 2015 this weekend.