Appearing on ABC's "This Week" with George Stephanopoulos, Kentucky Sen. Rand Paul claimed that his state's healthcare exchange — which has been touted by many Democrats as an Obamacare success story — had automatically enrolled one of his sons into Medicaid. Paul described going through a bureaucratic headache before sharing his conclusion that "most" of those using Kentucky's healthcare exchange were being "automatically enrolled in Medicaid."
Paul's story was quickly picked up by lots of right-wing media outlets eager to tarnish one of Obamacare's better examples. But according to a new report from Mother Jones, there's a problem with Paul's story, and that problem is rather simple: It doesn't make any sense.
Mother Jones spoke with Jill Midkiff, communications director for Kentucky's health department, who said, "We're not automatically enrolling people [into Medicaid]. People have to actually go and apply." Moreover, while Obamacare had a provision allowing states to automatically enroll into Medicaid those citizens who were already receiving government-provided social services, Kentucky rejected that option, choosing instead to simply notify relevant Kentuckians of their eligibility. There's no way, in other words, that Paul's son would've been entered into Medicaid without signing up for it first.
Midkiff couldn't discuss the Paul family's specific troubles due to confidentiality laws. But her general description of the state's exchange clearly contradicts Paul's story. When a Kentuckian visits Kynect, the state's health insurance website, she's asked to provide basic information about herself—age, location, income, number of dependents, etc.—to determine whether she qualifies for the Medicaid expansion or other insurance subsidies. The website is designed to encourage people who are eligible for Medicaid to apply, but it doesn't force anyone onto the Medicaid rolls. The applicant would still have to actively choose to enroll in a specific Medicaid plan.
"In general, individuals with income below 138 [percent] of the federal poverty level [about $15,000 for an individual] may qualify for Medicaid coverage," Midkiff says. "However, individuals at any income level…can still purchase coverage directly from insurers. They can also still purchase through the exchange—they just have to pay full price. They are not required to enroll in a plan through Kynect unless they are enrolling in Medicaid or seeking subsidies."
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