KELLY MCEVERS, HOST:
Supporters of the Affordable Care Act often point to Kentucky as one of the law's success stories. Five hundred thousand people in Kentucky have signed up for health insurance through the state-run exchange known as Kynect. And the exchange didn't have the technical problems that the federal one did. But now, Kentucky's new Republican governor, Matt Bevin, has told the federal government he will scrap the exchange. Kentucky Public Radio's Ryland Barton reports it would be first state to fully dismantle its exchange.
RYLAND BARTON, BYLINE: After Kentucky opened Kynect, the state's uninsured rate dropped by more than half to 9 percent within two years. Bevin made opposition to the federal health care law a central part of his campaign. Here's Bevin's inaugural address last month.
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MATT BEVIN: We are going to shut that redundant program down. This is what we are going to do next year.
BARTON: Bevin declined an interview request, but his office says that current enrollees in Kynect will be able to keep their current insurance through 2016. Then people will have to transition onto the federal exchange if they want to keep their plans. Emily Beauregard, executive director of Kentucky Voices for Health, says many people may have trouble signing up again.
EMILY BEAUREGARD: We may lose some folks who had been on the - on Kynect and enrolled in a plan that they liked but then for whatever reason don't reenroll through the federal exchange.
BARTON: Shutting down the exchange may hit the state's 400,000 Medicaid recipients particularly hard. The Affordable Care Act requires states to have an online portal for Medicaid. But the Bevin administration hasn't said how Kentucky will sign up recipients once Kynect is shut down. Jennifer Tolbert follows state health policy at the Kaiser Family Foundation.
JENNIFER TOLBERT: There will confusion generated for Medicaid beneficiaries as to where they go to sign up if they have previously applied for coverage through Kynect. Again, I think that's another open question.
BARTON: Governor Bevin has also indicated that by 2017 the state will scale back the state's expanded Medicaid program to a program that requires participants to put, as he puts it, skin in the game. Republican State Senator Ralph Alvarado is an ally of Bevin's and says the state can't afford it even though the federal government provides almost all the money.
RALPH ALVARADO: The governor ran on that. People responded, voted for him. He's following through on his promise. And I think he's going to try to get our financial house in order right now for the state. We've got a lot of expenses.
BARTON: In fact, Bevin's plans to scale back Obamacare in Kentucky may end up costing the state money. The previous administration estimated that dismantling Kynect would cost $23 million. For NPR News, I'm Ryland Barton in Frankfort, Ky.