WASHINGTON — Gov. Steven L. Beshear of Kentucky offered a vivid defense of his expansion of Medicaid under the Affordable Care Act on Friday, imploring Matt Bevin, the Republican governor-elect, to “look at this from a business standpoint, if not from a human standpoint,” and keep the program in place.
Mr. Bevin, a businessman who comfortably defeated Attorney General Jack Conway last week, frequently attacked the health law on the campaign trail. He initially vowed to reverse the state’s expansion of Medicaid, which has provided health coverage to an additional 425,000 low-income people, including many adults with no dependent children.
But more recently, Mr. Bevin has suggested he would seek federal permission to reshape the program, requiring participants to contribute to the cost of their coverage and possibly scaling back eligibility, something no state has received permission to do under the terms of the health law.
In a news conference in Frankfort, Mr. Beshear, a Democrat who is leaving office because of term limits, offered facts and figures to back up his argument that expanding Medicaid would save the state money and improve, as he put it, “our collective public image.”
Pointing to Kentucky’s long battles with health scourges like obesity and cancer, he said the state was finally turning a corner.
“They have hope and opportunity for good health for the first time in their lives,” he said of the state’s newly insured. “It’s the moral and ethical thing to do. And if you want to talk about it in religious terms, it’s the Christian thing to do as well.”
In a written response, Jessica Ditto, a spokeswoman for Mr. Bevin, said his “health care vision” for the state “will encourage personal responsibility and focus on expanding access to quality, affordable health care coverage.”
“Personal responsibility” has become a buzz phrase in Republican-controlled states like Arkansas, Indiana and Michigan, where elected leaders have won federal waivers to experiment with alternative forms of Medicaid expansion. Those states require people over a certain income level to make monthly payments toward their coverage and reward them if they seek preventive care.
In the statement, Ms. Ditto also raised something Mr. Bevin has pointed to as evidence of the Affordable Care Act’s failure in Kentucky: the financial collapse of Kentucky Health Cooperative, a new nonprofit insurer that sold private plans through the state’s insurance exchange, Kynect. The co-op has more than 50,000 customers who will continue to receive coverage through it until Jan. 1, but will then need to find new insurers.
“Those Kentuckians know firsthand the failures of Obamacare,” she said.
Mr. Bevin has also pledged to get rid of Kynect, which the state received more than $283 million in federal funds to build, and rely instead on the federal insurance exchange that serves 37 states. Most Republican-controlled states refused to build their own exchanges out of opposition to the health law.
“It’s inconceivable to me why, just to make a partisan political statement, Kentucky would want to go backward and become the first state to decommission a successful exchange,” Mr. Beshear said in the news conference, his first public appearance since Election Day.
Mr. Beshear added that the state would have to spend at least $23 million to dismantle Kynect.
Citing data that suggested more Kentuckians were getting preventive care and testing, Mr. Beshear said offering Medicaid to a larger pool of residents would eventually lead many of them to become more productive citizens.
“Folks,” he said, “if you’re healthy, you’re a lot more able to take a job, make a living and come off Medicaid because you make too much.”
Adding that he had already spoken privately with Mr. Bevin, he said: “He made no promises one way or the other, but he’s a business guy and he’s used to looking at facts and figures and data. So that’s what I’m encouraging him to do.”