Kentucky health insurance

Anthem, CareSource offer plans for 2020 through state's exchange; Medicaid work requirement has been terminated by Gov. Beshear, and Kynect will be the exchange platform again as of November 2021

Gray's Landing, Stewart County | by Andy McLemore

Health insurance in Kentucky

This page offers assistance to consumers seeking health insurance resources in Kentucky. Here, you’ll find helpful information about the many types of health insurance coverage available. You can find an overview of the Kentucky health insurance marketplace and upcoming open enrollment period; a look at the Medicaid expansion status in Kentucky; a quick look at short-term health insurance availability in the state; statistics about state-specific Medicare rules; as well as a collection of health insurance resources for Kentucky residents.

Kentucky’s health insurance marketplace

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

How hard is Kentucky fighting to preserve the Affordable Care Act’s provisions? Compare to other states’ efforts.

Kentucky initially operated its own exchange and enrollment web site, Kynect, and the state-run exchange was widely considered one of the most successful state-run exchanges in the country. But former Gov. Matt Bevin, who was in office from late 2015 through late 2019, followed through on a campaign promise to transition the Kentucky exchange to the HealthCare.gov platform.

Kentucky technically still has a state-run exchange, though, and is one of five states that have state-run exchanges but use HealthCare.gov for enrollment. And as of the 2022 plan year, Kentucky will once again have a fully state-run exchange. Gov. Andy Beshear has notified CMS that Kentucky will transition back to Kynect as of November 2021.

Kentucky open enrollment period and dates

Open enrollment for 2021 coverage in Kentucky will run from November 1, 2020 to December 15, 2020. Outside of that window, residents with qualifying events can still enroll or change their coverage for 2020.

For 2020, the state’s exchange is offering individual plans from two health insurance companies (Anthem and CareSource). CareSource expanded its coverage area for 2020, so there are 56 counties where residents can select from both Anthem and CareSource. In the rest of the state, plans are available from one or other of the insurers, but not both.

The average approved rate changes for 2020 were a 9.7 percent increase for Anthem and a 4.5 percent decrease for CareSource.

83,139 people enrolled in private individual market plans through Kentucky’s exchange during the open enrollment period for 2020 coverage.

Read more about the Kentucky health insurance marketplace.


Kentucky’s failed CO-OP

The ACA established a federal loan program to encourage the creation of Consumer Operated and Oriented Plans (CO-OPs), which are nonprofit, consumer-run health insurance companies. Through the program, 23 CO-OPs were set up as of January 2014, including the Kentucky Health Care Cooperative. However, 19 of them, including Kentucky’s, have folded.

Kentucky Health CO-OP had robust enrollment in 2014, and had planned to expand into neighboring West Virginia for 2016. But the CO-OP shut down at the end of 2015, along with several others that closed at the same time, due in large part to the significant shortfalls in risk corridors funding that year.

Read more about the Affordable Care Act’s CO-OPs.

Medicaid eligibility and expansion in Kentucky

In addition to implementing a state-run health insurance exchange, Kentucky expanded Medicaid under the Affordable Care Act. Under the Medicaid eligibility expansion, Kentucky residents with household income up to 138 percent of the federal poverty level are eligible for Medicaid.

Kentucky Medicaid enrollment nearly doubled between 2013 and 2020 – by far the largest percentage increase of any state, and more than four times as much as the national average increase of 23 percent.

After the Trump Administration clarified that they would be open to the possibility of work requirements for Medicaid, Kentucky was the first state to receive federal approval to implement a Medicaid work requirement, which was slated to take effect in July 2018. But in June, a federal judge blocked implementation Kentucky HEALTH.

The waiver was reapproved by HHS in November 2018, with an effective date of April 2019. but the work requirement was blocked again, just days before it was to take effect. And in December 2019, just days after taking office, Gov. Andy Beshear terminated the Kentucky HEALTH waiver, officially rescinding the state’s Medicaid work requirement.

Visit the Kentucky Department for Medicaid Services web site for information about the state Medicaid program and the Kentucky Children’s Health Insurance Program (KCHIP).

Read more about Medicaid expansion in Kentucky.

Availability of short-term health insurance in Kentucky

Kentucky defaults to the federal rules regarding short-term health insurance. That means plans sold in the state can have initial terms up to 364 days and a total duration of up to three years, although many of the plans for sale are limited to six months.

Read more about availability of short-term health insurance in Kentucky.

Kentucky health ratings

When it comes to public health, Kentucky faces some challenges. The state has received low rankings from various evaluations in recent years.

Kentucky ranked 43rd in the 2019 edition of America’s Health Rankings, and 40th in the Commonwealth Fund’s 2019 Scorecard on State Health System Performance.

How has Obamacare helped KY?

In 2013, Kentucky’s uninsured rate was 14.3 percent – just slightly lower than the national average at that point. But by 2016, the state’s uninsured rate had dropped to 5.1 percent, which was well below the 8.6 percent national average at that point. This reduction was due in large part to the state’s highly successful state-run exchange (Kynect) and the expansion of Medicaid under the ACA.

But when the 2017 open enrollment period began on November 1, 2016, Kentucky residents switched to using HealthCare.gov for enrollment. Former Gov. Matt Bevin, who took office in 2015, transitioned the state to the federal enrollment platform in an effort to curtail costs and take advantage of HealthCare.gov’s economies of scale.

Kentucky still has a state-based exchange, but they no longer have the autonomy that goes along with having a state-run enrollment platform. As an example, when the open enrollment period for 2018 coverage was cut in half, 10 of the 12 states with state-run enrollment platforms opted for longer enrollment periods, and most continued to do so for enrollment in 2019 and 2020 plans (as of 2020, there are 13 fully state-run exchanges). But states like Kentucky, that use HealthCare.gov, don’t have that level of flexibility. That will change in Kentucky as of late 2021, when the state transitions back to the Kynect platform and stops using HealthCare.gov.

The Affordable Care Act in the Bluegrass State

In the 2010 vote on the Affordable Care Act (aka Obamacare), Kentucky’s two Republican senators voted “no.” Kentucky’s current senators – Mitch McConnell and Rand Paul – remain firmly opposed to the ACA.

Kentucky’s representatives in the House split their votes on the ACA along party lines, with two yes votes and four no votes. Kentucky’s current Representatives include five Republicans and just one Democrat. One of the Republicans, Thomas Massie, was among 20 Republicans in the House of Representatives who voted no on the American Health Care Act in 2017, which would have repealed several major portions of the ACA. That bill passed in the House, but failed to pass in the Senate and was never enacted.

At the state level, former Gov. Steve Beshear’s support of the ACA repeatedly drew national attention, with even President Obama making note of it during his 2014 State of the Union address. Beshear used an executive order to establish Kentucky’s state-run health insurance marketplace, Kynect.

Kynect was viewed as a model for state-run marketplaces. Beshear also fully supported Medicaid expansion, calling it the “single most important decision” for improving the health of Kentucky residents.

Kentucky elected Republican Matt Bevin as governor in the 2015 election. Bevin campaigned on an anti-Obamacare platform, and shut down the state-run exchange platform less than a year after taking office. Steve Beshear’s son, Andy Beshear, defeated Bevin in the 2019 election, and is planning to switch the state back to the Kynect platform in the fall of 2021 (as of 2020, Kentucky is one of five states that has a state-based exchange but uses HealthCare.gov for enrollment).

Does Kentucky have a high-risk pool?

Before the ACA reformed the individual health insurance market, pre-existing conditions were a barrier to obtaining coverage in nearly all states, including Kentucky. Medical histories were scrutinized during the application process, and people who didn’t meet the health eligibility guidelines were unable to purchase private coverage. Kentucky Access was established in 2001 to offer coverage to people who were not able to get policies in the individual market because of pre-existing conditions.

Under the ACA, all new health insurance policies became guaranteed issue starting on January 1, 2014. This aspect of reform largely eliminated the need for high-risk pools, and Kentucky Access notified their members that the plan would cease operations at the end of 2013. Insureds were able to transition to private coverage through Kynect instead.

Medicare coverage and enrollment in Kentucky

There were 937,472 Kentucky residents enrolled in Medicare as of April 2020.

Learn more about Medicare in Kentucky.

Kentucky healthcare reform legislation

Scroll to the bottom of the page to see what’s happening legislatively in Kentucky with healthcare reform at the state level.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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