Kentucky health insurance marketplace: history and
news of the state’s exchange

BCBS of Kentucky and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

More Kentucky coverage

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    Insurance Guide
    • A guide to health insurance in
      your state.
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    • Your state’s Medicaid expansion,
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    • Insurance for those over 64

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Kentucky exchange overview

Kentucky is currently one of five states that have state-run exchanges but use for enrollment. Governor Matt Bevin, who took office on 2015, wanted to repeal Kentucky’s Medicaid Expansion but was declined. As a result of this, Kentucky was the first state in America to receive federal approval for a Medicaid work requirement. Furthermore, Kentucky’s Medicaid program will eliminate the retroactive coverage. After the Affordable Care Act, the uninsured rate in Kentucky went from 14.3% in 2013 to 5.1% in 2016.

For the 2018 open exchange, there will be two carriers in the state of Kentucky: Anthem Blue Cross Blue Shield and CareSource Kentucky. Both had high rate increases but they were due to cost of cost-sharing reductions being added to silver plan rates.

Kentucky Health Ratings

In the 2017 Common Fund’s Scorecard on State Health System Performance, Kentucky ranked 39th which was up one spot from 2015. Kentucky scored the highest in the Access category and the lowest in Avoidable Hospital Use and Cost category. According to America’s Health Ranking in 2015, Kentucky ranked 442nd which was in increase from previous years.

Kentucky and Obamacare

As mentioned earlier, the uninsured rate dropped from 14.3% to 5.1% in just three years. In comparison, the national average is 8.6%. This reduction is due to the state-run exchange (Kynect) and the expansion of Medicaid. When Governor Matt Bevin transitioned the sate run program to a federal level, the state-run enrollment platform opted for longer enrollment periods.

Kentucky and Qualified Health Plans

Kentucky’s enrollment in private plans dropped 12% from 2015 to 2016. 43% of the state’s 285,000 uninsured were eligible under the Medicaid expansion. Furthermore, enrollment dropped in 2017 when the state switched to and reduced marketing and advertising. Only 81,155 people enrolled in 2017. However, for 2018, enrollment grew by 10% which was the second highest state increase in the country, just behind Rhode Island.

Kentucky Medicaid/CHIP

In the state of Kentucky, residents who make under $32,913 for a family of four are eligible for Medicaid. There were 358,000 residents who were eligible for Medicaid or the Children’s Health Insurance Program (CHIP) during the Affordable Care Act’s open enrollment.


Risks in Kentucky

In 2001, Kentucky Access was enacted for offer coverage with those who had pre-existing medical conditions and were unable to get health care. Under the Affordable Care Act, all new health insurance policies became guaranteed issue starting January 1, 2014. This eliminated the need for high-risk pools and Kentucky Access was eliminated in 2013.


Kentucky Medicare

Kentucky Medicare enrollment reached 862,887 enrollees which is 20% of the state’s population in 2015. Kentucky has the highest number of Medicare enrollees who are disabled—25%. The other 75% qualify for Medicare on age. Annually, Medicare pays $8,891 per Kentucky enrollee.

Nationally, 33% of Medicare beneficiaries choose a Medicare Advantage plans over traditional Medicare Coverage. In Kentucky, 28% of enrollees opted for a Medicare Advantage Plan.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.