Guest Blogs by KCEP: Medicaid’s Impacts on Health and Economies in Appalachian Kentucky

Today, we’re reprinting two blogs with permission from the Kentucky Center of Economic Policy (KCEP). The first looks at the coverage gains and economic impacts that expanded Medicaid has brought to the state of Kentucky; the second looks at the potential drop in enrollment should the Governor’s proposed changes be accepted by the federal government.  

The federal comment period on the proposed changes to Kentucky Medicaid closes Saturday, October 8th at 11pm. You can leave your comments by visiting  


A County-by-County Look at the Medicaid Expansion

By Dustin Pugel
December 18, 2015

A total of 425,782 Kentuckians were insured through the Medicaid expansion as of October. By county, between 3.7 and 19.1 percent of the population were covered and a total of $2.7 billion from the Medicaid expansion has flowed to providers. Especially benefiting is rural Kentucky. Perry County had the highest percentage of residents insured through the program with nearly 1 in 5 covered. Perry county also ranks 5th in Medicaid expansion money flowing into the county at $62.8 million since the beginning of the expansion.

The expanded Medicaid program in Kentucky is a crucial source for healthcare for hundreds of thousands of Kentuckians across the Commonwealth. Ensuring that these residents can continue to receive healthcare without cost barriers is critical to the future health of our state.


A County-by-County Look at Potential Enrollment Decreases from Proposed Medicaid Waiver

By Dustin Pugel
September 1, 2016
The Governor is seeking to make changes to Kentucky’s Medicaid program in a way that would result in 87,639 fewer traditional and expanded Medicaid enrollees by 2021, according to official projections. This represents a total drop in enrollment of 6.6 percent from the starting point of October 2015. What does that mean across Kentucky counties?

The map below shows how many people would likely lose coverage in each Kentucky county if the enrollment drops were proportional to the traditional and expansion Medicaid population in counties. Enrollment drops are steepest in eastern Kentucky, as the map shows.

Reducing enrollment means more uncompensated care for hospitals, less state agency savings when they have to pay for what Medicaid was covering, fewer jobs in the healthcare sector and less healthy Kentuckians. While the Bevin administration and Washington officials negotiate elements of the waiver, real people across Kentucky counties have a lot to lose.


To read more in-depth coverage of the impacts of Medicaid on Kentucky, and about the state of Kentucky healthcare in general,  visit the Kentucky Center for Economic Policy