Public health researchers track transformative period of Kentucky health policy

Health care insurance coverage remains a contested policy issue in Kentucky years after the implementation of the Affordable Care Act (ACA).

Since the federal legislation was signed into law in 2010, University of Kentucky College of Public Health researchers Julia Costich and Glen Mays have participated in a project that has tracked and analyzed the progress of state-enacted health care policies in 40 states, including Kentucky. Costich and Mays recently completed a report outlining the changes under discussion for health care reform policy in Kentucky. In the special report, which was published in partnership with the Rockefeller Institute of Government of the State University of New York (SUNY) and the Brookings Institution, the authors found that public policy decisions unfolding in Kentucky will have major economic and political implications for the state and could serve as harbingers of change in other states.

"Kentucky's approaches for navigating the many uncertainties of health reform offer important lessons for the rest of the nation," Mays, the Scutchfield Endowed Professor of Health Services and Systems Research, said. "Every state is learning by doing, so by comparing these experiences we can determine which solutions work best in which contexts."

Mays, who also serves as the director of the Systems for Action Research Center housed at the College of Public Health, and Costich, a professor in the Department of Health Management and Policy, cited progress in Kentucky to reduce the number of individuals living without health care coverage. The state-based exchange program, branded kynect, has enrolled more than half a million Kentuckians.

"What's happening in Kentucky will thus test the durability of the ACA and perhaps reveal new directions for its implementation," the authors state in the report.

Richard Nathan, a senior fellow at the Rockefeller Institute and project co-director, applauded the Kentucky report, underscoring its significance in recording an unprecedented and transformative era of health care policy.

"Costich and Mays tell an important story about how Kentucky went about doing what's in the law and now how hard it is to un-do it," Nathan said. "There's a lesson here worth close scrutiny."