GUEST COLUMN: Working is no guarantee you’ll have health insurance

FRANKFORT — Kentucky elects 138 people to serve in the state legislature, and 98 of them get their health insurance through the state-sponsored plan for public employees.

Kentucky lawmakers also enroll 138 dependents in the state employees' health plan.

I bring this up not because I begrudge lawmakers and their families health insurance. Everyone should have health insurance. Not having health insurance is irresponsible if there's any way you can swing it.

I bring this up because Republican politicians have been talking a lot lately about who deserves and who does not deserve to be insured by Medicaid, the government program that Kentucky expanded 11 years ago to include low-income adults who often are described as the "working poor."

Medicaid also covers people who have disabilities, children, moms-to-be, new moms and seniors. A third of Kentuckians get their medical care through Medicaid.

Republicans in D.C. and Frankfort have taken steps to winnow out those they consider undeserving. To partially pay for President Donald Trump's tax cuts and immigrant roundups, the number of Americans without health coverage is projected to increase by 17 million, according to the Congressional Budget Office. In addition to lowering Medicaid spending by $1 trillion over the next 10 years, the Big Beautiful Bill Act also cuts subsidies to the Affordable Care Act insurance marketplace. Meanwhile, a tax credit that helps people afford health insurance is set to expire.

Republicans tell us their goal is to promote self-sufficiency and that their plans to boot the moochers, malingerers and sex-changers off the rolls will make Medicaid stronger.

As GOP U.S. Rep. Andy Barr said earlier this year on Fox Business: "This is good for people who are currently on Medicaid in Kentucky and around the country. We want people to not be on Medicaid. We want them to have good private sector jobs that pay them more and give them better quality private health insurance."

Well, sure, we also want that free Bubble Up and rainbow stew of which the late poet Merle Haggard sang.

But let's be real.

You can have a job — or a few jobs — and still not have health insurance or an offer of health insurance that you can afford.

A lot of Kentuckians who have jobs can afford health care only because of the Medicaid expansion.

Nationally only about half of small employers (those employing fewer than 50 people) sponsor a health insurance plan for their workers, and in Kentucky the share of small employers offering health insurance is lower than the national average.

Overall, about 1 in 4 workers are not eligible to enroll in employer-sponsored insurance. Even large employers are not required to offer health insurance to employees working fewer than 30 hours a week.

Which brings us back to the Kentucky legislature. It's a part-time job that's not meant to provide a primary livelihood. That 70% of lawmakers use this part-time job to insure themselves tells me that access to "quality private health insurance" is not as plentiful as Rep. Barr suggests.

(You might suppose Barr, a Phi Beta Kappa who's running for U.S. Senate, would know better, but, in his defense, he has had government-provided health insurance most of his adult life as a member of Congress or a government staffer.)

I did not ask for any lawmakers' names when I filed my open records request with the Personnel Cabinet; I asked only for the number of lawmakers enrolled in the state health insurance plan.

Arithmetic tells us most of them are Republicans, since there are only 26 Democrats in the General Assembly.

Lawmakers and their families don't have to go through a full redetermination process or prove their "community engagement" every six months to keep their coverage — in contrast to the work requirements (really, paperwork requirements) that Republicans are imposing on working-age adults in Medicaid.

Monthly premiums for a single enrollee in the four plans for state employees range from $61 to $169.

Lawmakers over the years also have voted themselves nice pensions, giving them a degree of economic security unknown to many of their constituents, who, even if they have 401K plans at work, are at the mercy of investment markets for security in their later years.

I don't begrudge lawmakers their health insurance or their pensions. Legislative pay is low.

Still, you have to shake your head when lawmakers who have feathered their own nests use their power to punish people who don't even have a nest to feather.

Instead of figuring out how to kick people off health care, our elected leaders could do us all a favor by figuring out how to make the system work better for everyone.

Jamie Lucke has more than 40 years of experience as a journalist. Her editorials for the Lexington Herald-Leader won Walker Stone, Sigma Delta Chi and Green Eyeshade awards.