Saturday, May 25, 2013

Open letter to President Barack Obama

President Barack Obama
The White House
1600 Pennsylvania Avenue
Washington D.C. 20500

Dear Mr. President,

We need your help with a unique problem in Kentucky.

As you probably know, the Bluegrass State is the only state in the nation to vote against you twice and then take steps to implement both a state-run exchange and the optional Medicaid expansion.

While that may not present much of a political problem per se, it could add to a logistical nightmare of the Affordable Care Act rollout because Kentucky literally is in no position to participate and there is no likelihood of that changing soon enough.

To be specific, under Kentucky law we can not participate in either the state-run exchange or the optional Medicaid expansion. I know you have been advised otherwise by Governor Steve Beshear, but he hasn't told you everything you need to know.

On July 17, 2012, Governor Beshear filed Executive Order 2012-587 purporting to create a "Kentucky Health Benefit Exchange," citing "the Constitution of the Commonwealth of Kentucky and KRS 12.028" as his authority for unilaterally taking this action.

Put some staffers on the task of verifying this supposed claim of authority by Governor Beshear. It will not take long to recognize the truth that it can't be done. It simply is not a valid exercise of executive power under Kentucky law. Further, a lawsuit already underway in state court will likely quite soon force Governor Beshear to request of your Administration the rushed creation of a federally run exchange.

A possible alternative, of course, is an extraordinary session of the Kentucky General Assembly to provide the Governor necessary authority to implement a state-run exchange, but current political realities should inform us that such would not be productive.

For these reasons, the people of Kentucky need your Administration to advise Governor Beshear to cease his illegal activity related to creation of the Kentucky Health Benefit Exchange.

Also, please be advised that another lawsuit to forestall acceptance of the Medicaid expansion has also reached state court. The case against this action is somewhat less obvious, but no less clear. KRS 205.520(3) confers unlimited powers upon the state secretary for health and family services to seek federal funds relating to "medical assistance." However, Section 2 of Kentucky's Constitution forbids exercise of absolute power in the state. The only legitimate way Governor Beshear can obligate Kentuckians to the costs associated with this activity is with legislative cooperation. Again, such is not at all likely to be forthcoming.

Any assistance you can give us in regard to advising Health and Human Services officials of Kentucky's inability to comply with these optional portions of the Affordable Care Act would be beneficial for all parties  involved and is greatly appreciated.


David Adams
121 Nave Place
Nicholasville, KY 40356