Price spikes set to leave thousands of Kentuckians without health insurance, advocates say

While some Kentucky Republicans in Congress accuse Democrats of shutting down the government to get "free health care for illegal aliens," advocates are warning that thousands of U.S. citizens in Kentucky will no longer be able to afford health insurance next year.

Democrats in D.C. are pushing Republicans to take action now to ease premium spikes that stem in part from policies signed into law by President Donald Trump earlier this year. Republicans insist the health care issues should be negotiated after Congress passes a funding bill to reopen the government.

In Kentucky, health insurance premiums on the Kynect marketplace are set to increase by as much as 37% for individuals and 18% for small groups, according to data from the state Department of Insurance.

Open enrollment begins Nov. 1. Almost 100,000 Kentuckians get their health coverage through Kynect, which opened in 2014 as part of the Patient Protection and Affordable Care Act.

Health insurance premiums are expected to skyrocket across the country, in part because of rising medical costs but also because enhanced tax credits that have made the policies more affordable since the Covid-19 pandemic are set to expire unless Congress acts.

Insurers expect the higher premiums will reduce enrollment — especially among the young and healthy — which will destabilize the market and raise premiums for the shrunken pool of enrollees who remain.

Insurers and hospitals also are bracing to pay for more uncompensated care in the future because of cuts to Medicaid the Republican Congress approved this summer.

Democrats want the funding deal to include renewing the health insurance subsidies.

Dishonest debate?

Kentucky U.S. Reps. Hal Rogers and Andy Barr are joining other Republicans in mischaracterizing the Democrats' demands as free health care for noncitizens.

Rogers, who represents Eastern Kentucky, issued a press release saying Senate Democrats rejected the continuing resolution because they were "demanding nearly $1.5 trillion in reckless spending and free healthcare for illegal immigrants."

Barr, who represents Central Kentucky and is running for U.S. Senate in 2026, also echoed the party line that Democrats are seeking "taxpayer-funded health care for illegal aliens" in an interview on Fox News earlier this week.

U.S. Rep. Brett Guthrie said in a Tuesday press release that Democrats should "stand up to radicals in their party and vote to keep the government open."

Rogers' claim drew a rebuke from one of his constituents, Christian Matson, who said the congressman was lying about Democrats' demands. Matson said he emailed Rogers Wednesday to let him know that he was offended by the congressman's mischaracterization and that he was worrying about how he would pay for his own health care.

Matson, a self-employed resident of Pikeville who serves as a diocesan hermit of the Catholic Diocese of Lexington, gets health insurance through the Kynect marketplace. He said covering the increased premium costs is "not in the budget right now" and could mean cutting other expenses, including groceries and visits to the doctor.

He said he found it offensive and dishonest for Rogers to "lie to his constituents" by singling out immigrants.

Matson, who said he's not a registered voter with either major political party, told the Lantern he reaches out to Rogers' office regularly to voice his concerns on a number of issues. "If we're going to have debates about how to solve issues in our country, we have to do them honestly," he said. "We need to do better."

Undocumented immigrants are generally barred from receiving federally funded health care and other benefits. They are not eligible in Kentucky for coverage through Medicaid, the free federal-state program that pays for 1 in 3 Kentuckians' health care, although there are exceptions for emergencies and pregnant women.

"Lawfully present immigrants" can buy insurance through the Affordable Care Act marketplaces.

"There's no proposal to expand eligibility," Emily Beauregard, executive director of Kentucky Voices for Health, said Wednesday.

"We're going to see a lot of people who just have no options for affordable health insurance. And I think that's going to be a big problem for all of us," Beauregard said.

The Urban Institute estimates the higher costs would force as many as 18,000 Kentuckians out of the Affordable Care Act marketplace, and that most of them would become uninsured.

Premium increases reflect several factors

Jason Bailey, the executive director of the Kentucky Center for Economic Policy, told the Lantern that a wide swath of Kentuckians who utilize the health care subsidies could face "sticker shock" when open enrollment begins in November.

He said Kentuckians who choose to go uninsured will still need health care, and the costs of caring for more uninsured people would fall on hospitals or taxpayers.

"The cost will have to be picked up somewhere as a result of people then becoming uninsured," Bailey said. "I think it's right to demand that these health costs aren't allowed to spike." Bailey said the Republican rhetoric about free health care for noncitizens is "completely false."

A spokesman for Anthem Blue Cross Blue Shield in Kentucky said the upcoming premium increases on Kynect reflect the cost of care and the loss of subsidies. People insured through the Affordable Care Act marketplace have higher rates of accessing care and need more complex care, he said. "As an example, these members are utilizing the emergency room at nearly two times the level of our members with employer-sponsored plans. Additionally, the enhanced premium tax credits — which will expire this year unless extended by Congress — have been critical to improving affordability for our members."

Anthem has been approved in Kentucky to increase premiums for individual plans by 24% and for small group plans by 18%.

Rogers, a Republican congressman, said he voted for the extension "on behalf of our military servicemembers who will not be paid until the shutdown ends."

"Political games have no place when it comes to taking care of our American heroes. Washington Democrats voted for the same short-term extension 13 times during the Biden Administration, but now they want to trade it for free healthcare for illegal aliens and nearly $1.5 trillion in reckless spending," Rogers said. "Their vote to shut down the government is absurd. The American people deserve better."

One Kentucky Republican said, "Both parties are ridiculous!"

U.S. Rep. Thomas Massie, who has long had vocal concerns about the increasing national debt, said on X Tuesday evening that Republicans have "passed a line-by-line continuation of Biden's last budget, including Doge-identified waste" while Democrats "refused to vote for Biden's last budget, thereby shutting down the government."

"I voted Nay when it was for Biden, and I'm Nay now," Massie said.

Kentucky's lone Democrat in Congress, U.S. Rep. Morgan McGarvey, of Louisville, joined other members of his party in blaming Republicans for the shutdown. In a Tuesday statement, he said the GOP controls the White House and Congress, but "they would rather shut the entire government down than pass a budget that actually gives families a fair shake."

"I'm here in Washington to pass a budget that addresses rising costs like health insurance, but House Republicans are nowhere to be found," McGarvey said. "They need to get back to Washington to work with us on lowering costs and opening the government back up."

Republican U.S. Sen. Mitch McConnell said on X, "I can't count the number of times I've had to remind Democrat colleagues that taking basic government functions hostage for partisan demands never pays. This shutdown won't end until Democrats re-learn this lesson. For the sake of the American people, I hope they do so quickly."

Democratic Gov. Andy Beshear issued a statement saying, "The federal government is shut down because the president refuses to keep his campaign promises to preserve affordable health care for millions of Americans. I hope folks in D.C. will put American families first and reopen our federal government while also taking the necessary steps to preserve affordable health-care coverage."