Adopted as Amended
2017-20
RESOLUTION
Subject: Health Care Coverage for the Medically Underserved
Submitted by: Greater Louisville Medical Society
Referred to: Reference Committee
WHEREAS, leaving citizens uninsured and underinsured causes them to delay prevention
and care, thus presenting with costly advanced-stage diseases, which imposes enormous
consequences of family suffering, preventable premature deaths (500-1000 per million persons per
year), avoidable bankruptcies (20K per million families per year) and vastly increased uncompensated
care costs ($4.4 billion per million uninsured per year) that are shifted to taxpayers, insured
policyholders and providers; and
WHEREAS, Kentucky health needs are far above national averages for cancer, metabolic
illness, nursing home needs, and substance abuse treatment/prevention, which are often greater in rural
and medically underserved areas (83 of Kentucky’s 120 counties) with substantial Medicaid-eligible
populations; and
WHEREAS, Medicaid expansion, a component of the 2010 Affordable Care Act, greatly
increases skilled chronic disease management, prevention measures and early treatment, which now
protects over one-half million Kentuckians and their families from the above-cited harm, and brings
substantial economic relief from uncompensated care costs shifted to providers and all taxpayers and
insured policyholders; and
WHEREAS, currently considered national and State proposals (including the Kentucky
HEALTH 1115 waiver application) reduce numbers of insured and thus raise total health care costs
across America, and greatly more for Kentucky (most harmed of 50 states, ref: KY Center for Economic
Policy), which brings proportionately greater harm to rural and safety-net hospitals, and to physician
recruitment and retention in medically underserved areas; and
WHEREAS, the 10 Essential Health Benefits of 45 CFR 156.100 are: 1) ambulatory patient
services; 2) emergency services; 3) hospitalization; 4) maternity and newborn care; 5) mental health and
substance use disorder services including behavioral health treatment; 6) prescription drugs; 7)
rehabilitative and habilitative services and devices; 8) laboratory services; 9) preventative and wellness
services and chronic disease management; and 10) pediatric services, including oral and vision care. If
these are eroded or eliminated from Medicaid, individual or small group policies, the uncovered care
harms patients, and generates large costs that are shifted to taxpayers, insured policyholders and
providers; now, therefore, be it
KMA House of Delegates
August 2017