Closing Kynect and restructuring Medicaid threaten Kentucky's health and economy

Charles B. Wright, Nathan L. Vanderford

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Following passage of the Patient Protection and Affordable Care Act (ACA) in the United States, theKentucky Health Benefit Exchange,Kynect, began operating in Kentucky in October 2013. Kentucky expanded Medicaid eligibility in January 2014. Together, Kynect and Medicaid expansion provided access to affordable health care coverage to hundreds of thousands of individuals in Kentucky. However, following the Kentucky gubernatorial election in 2015, the newly inaugurated governor moved to dismantle Kynect and restructure the Medicaid expansion, jeopardizing public health gains and the state economy. As the first state to announce both the closure and restructuring of a state health insurance marketplace and Medicaid expansion, Kentucky may serve as a test case for the rest of the nation for reversal of ACA-related health policies. This article describesKynect and theKentucky Medicaid expansion and examines the potential short-term and long-term impacts that may occur following changes in state health policy. Furthermore, this article will offer potential strategies to ameliorate the expected negative impacts of disruption of bothKynect and the Medicaid expansion, such as the creation of a new state insurance marketplace under a new governor, the implementation of a private option, and increasing the state minimum wage for workers.

Original languageEnglish
Pages (from-to)719-737
Number of pages19
JournalJournal of Health Politics, Policy and Law
Issue number4
StatePublished - Aug 1 2017

Bibliographical note

Publisher Copyright:
© 2017 by Duke University Press.


  • Evidence-based policy
  • Health care reform
  • Implementation
  • Public health insurance
  • United States

ASJC Scopus subject areas

  • Health Policy


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