One problem with Vice President Mike Pence's assertion at a recent campaign rally in Louisville, Kentucky, that the Affordable Care Act is a "nightmare" that has "failed the people of Kentucky": after the passage of the law, Kentucky had the greatest percentage drop in uninsured Americans across the entire country.
Pence sold the Republican congressional plan to repeal the ACA and replace it with a mandate and subsidy-free system of tax credits to Kentuckians as a way to offer states greater flexibility, according to the Courier-Journal. But data as collected by Gallup in February 2017 showed the state's uninsured rate for adults dropped by 12.6% — from 20.4% to just 7.8% — between 2013 and 2016, meaning well over 500,000 people obtained insurance after the law went into effect.
As the Courier-Journal also noted, GOP Kentucky Gov. Matt Bevin also denounced the law at the speech, saying "Obamacare is a disaster. It needs to be repealed. It needs to be replaced!"
But a recent Bloomberg piece noted that while Bevin campaigned in his gubernatorial on a largely anti-ACA platform, he kowtowed to "political reality" after assuming office by applying for a waiver to tweak Kynect, the state's federally-funded health insurance marketplace enacted in accordance with the ACA. Rather than reject federal funds to expand Medicaid, Bevin (like Pence) instead sought waivers for "Republican-looking add-ons — premiums, punishments, so-called skin in the game for the poor — that allowed the governors to expand Medicaid under Obamacare, while saying they were doing something else," Bloomberg reported.
Bevin ended enrollment in the Kynect program in 2017, sending people back to the federal exchange.
Few places in the U.S. represent the challenges to the Republican-backed repeal bill, which the GOP has pitched as ensuring health care "access" rather than coverage. Though Republicans have campaigned on a platform of repealing the law for years, millions could stand to lose coverage they have only recently acquired. Thus the GOP making good on its promises could lead to terrible political consequences.
One cost estimate on Vox showed total annual health care costs could increase by thousands of dollars for average buyers on the individual markets; while premiums would be lower for most individuals, actual health care spending would increase dramatically, with those aged 55-64 paying $6,089 more on average.