FRANKFORT, Ky. -- Gov. Andy Beshear has announced he's planning to restart Kynect, the state-based health insurance exchange that allows people unable to get coverage through an employer to enroll in a health insurance plan or sign up for Medicaid if they qualify. Former Gov. Matt Bevin dismantled the program in 2017.

Currently, said Cara Stewart, director of policy advocacy at Kentucky Voices for Health, Kentuckians who want be insured through the Affordable Care Act have to apply through the one-size-fits-all federal platform on healthcare.gov. She said the state has no local control to tailor coverage to the needs of Commonwealth residents.

"Having your own state-based marketplace means that you have the final answer in Kentucky. It means that you can decide when to have open-enrollment periods," she said. "It would have meant that we could have had a special open-enrollment period because of the COVID-19 pandemic. We could have created an opportunity for people to enroll in coverage."

The federal government has so far refused to open a special enrollment period for health coverage through the ACA amid the pandemic. One study from Families USA estimated that, between February and May, more than five million Americans lost health coverage as a result of losing their jobs.

Stewart said an open-enrollment period for the state-based marketplace is likely to begin in fall 2021.

Northern Kentucky resident David said that for him and his wife, the current process has been time-consuming and confusing.

"What does make it complicated is we kind of have to navigate two completely different systems," he said, "one for me, for my Medicaid, and a totally different system for Marketplace."

Stewart said David's experience isn't unique, since the lack of a state-based system means more work for consumers. She said some people simply get discouraged and give up.

"Everything changes when you have to say, 'Well, if your income is above or below this line, then you're probably going to need to go through this website; and if it's above or below this amount, then you're probably going to go to this place. But we won't know for sure until we do it, and you might have to fill out two applications,'" she said.

The estimated $5 million plus operating costs to revive Kynect will be far lower than the roughly $10 million per year the state now pays to purchase health plans through healthcare.gov, Stewart said, a price tag set to increase to $15 million.

Beshear's Letter of Intent is online at governor.ky.gov.

Despite uncertainty about Medicaid funding in Congress, Tennessee is moving ahead to help improve people's health outcomes with a program for community health workers.

Tennessee's Medicaid program, TennCare, is partnering with the Tennessee Community Health Worker Association to offer an accreditation program to promote best practices for training and supporting the workforce.

Nikayla Boyd, executive director of the association, said community health workers link people to care and promote healthy habits. She noted the pilot accreditation program is underway, with a full launch expected by 2027.

"In addition to CHWs having individual certification, we are also accrediting the actual CHW program," Boyd explained. "Accrediting that program, that organization, that employer."

TennCare will fund grants for up to 14 organizations to complete the accreditation process. There are about 600 community health workers in the state, according to the U.S. Bureau of Labor Statistics, but Boyd argued more are needed.

Boyd pointed out they partner with the National Committee for Quality Assurance to design the accreditation programs. Some are centered on specific diseases, while others primarily address the social determinants of health.

"To date, we have six programs in Tennessee that have been accredited," Boyd outlined. "Two at Methodist Le Bonheur Community Outreach, two at Siloam Health, one at Regional One Health and then, another at the Mental Health Cooperative."

Boyd added an organization must meet seven standards in order to be accredited. For those working with community health workers, they include the full scope of training from recruitment to evaluations, support and supervision.


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Republican lawmakers are considering billions of dollars in cuts to Medicaid. But a new report finds those spending cuts might impact health-care coverage for thousands of Maryland military families.

The report by the Georgetown Center for Children and Families finds more than 850,000 people enrolled in Medicaid have military health insurance, known as TRICARE, as their primary coverage. One in 10 children of service members with TRICARE is also enrolled in Medicaid.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said Medicaid is important for service members with children who require more intensive health care.

"The TRICARE benefit package just isn't enough, so Medicaid is making TRICARE work for those families by covering the high cost of services and some benefits that those children otherwise would not have access to," Alker explained.

Republicans in Congress are trying to reel in what they view as out-of-control spending by $2 trillion in the next budget. But cuts to Medicaid are not universally agreed upon among Republican lawmakers.

Medicaid also serves 40% of children in the U.S. with a benefit that allows them to receive preventive and ameliorative care. That benefit began after a military report in the 1960s found young men were not qualified for military service in Vietnam because of preventive medical issues during their childhoods.

Retired Army Brigadier General George Schwartz said Medicaid cuts could have a negative impact on recruiting numbers as well. If troops lack proper coverage for their families, he thinks they may seek other career paths that can provide that coverage.

"As those young people reach the age where they're eligible for military service, the military is competing with private industry and all sorts of organizations for these young people. From a mission readiness point, this is a matter of national security," Schwartz contended.

Maryland is home to more than 100,000 active-duty service members and more than 35,000 military-connected children in the state.

With Mother's Day coming up, some Pennsylvania lawmakers are backing a set of bills that could help improve maternal health.

The Black Maternal Health Caucus introduced the updated "PA Momnibus 2.0" package in April, focused on tackling disparities in maternal health care by improving access to services.

Black women in the state are nearly twice as likely to die from childbirth complications. Rep. La'Tasha D. Mayes, D-Allegheny County, said 93% of maternal deaths are preventable.

"All the bills are for all moms, and because we know when we fix and address and take on maternal mortality and morbidity for Black moms, we solve it for every mom and birthing person in the Commonwealth," she explained.

The nine-bill package builds upon a 2024 "Momnibus" introduced by Mayes and Reps. Morgan Cephas and Gina Curry, both Republicans. Mayes said the caucus is working towards moving the bills toward votes, and then action in the Senate.

Two of the measures would expand access to blood pressure monitors and ensure they are covered through private insurance and Medicaid. Mayes added another measure would expand the reach of midwives, who provide care throughout pregnancy and childbirth, as well as postpartum.

"The Midwifery Practice Innovation bill that's going to help us advance midwifery as an occupation in this commonwealth, because it's very challenging to become a midwife, as well as be able to practice fully in a way that can serve moms," she continued.

The "Momnibus" also includes supports for nursing mothers, and invests in a Maternal and Newborn Supply Kit program, and maternal-health deserts. Mayes says more than 12% of women have no birthing facility within 30 minutes of their home, and Black women are three times more likely to die during or after birth compared with other women.