This is the first in a series, Women Leading Kentucky Health, of stories about four high-ranking female state officials who have guided the state’s embrace of the Patient Protection and Affordable Care Act.
Energy exudes from Carrie Banahan when she talks about her work with others to bring affordable health care to more than half a million Kentuckians.
“I worked all my life to see this happen, that we can provide affordable health insurance to people, and it has actually happened,” she said. “I am thrilled that we are actually helping people in Kentucky. It is the highlight of my career.”
Banahan is executive director of the Kentucky Health Benefits Exchange, which the state has branded as Kynect, partly to avoid identification with the pejorative nickname Obamacare. She shares the credit for its success.
“One thing that I am proud to say I am part of is our team in general,” she said in an interview. “Everybody is very dedicated to this project and wants it to succeed and believes, as we all do, that we are going to make a huge difference in people’s lives. We are going to improve the health status of Kentuckians.”
She attributes the success of Kynect to early planning, collaboration and teamwork. Outside state government, she credits the support of community groups and a pent-up demand in Kentucky for access to affordable health insurance.
Banahan was executive director of the state Office of Health Policy when the Patient Protection and Affordable Care Act passed in 2010. Gov. Steve Beshear immediately gave her the task of investigating whether Kentucky should establish its own health-insurance exchange.
Beshear decided to do that, but they had to wait until the U.S. Supreme Court ruled on the law. On June 28, 2012, the court voted 5-4 to uphold it, except the part that would have denied Medicaid funds to states that did not expand the program.
Beshear created the exchange and named Banahan its director. With its successful rollout little more than a year later, Kentucky has become the national model for how to start and run a successful state exchange.
Banahan knew the landscape of Kentucky health care and insurance because of her work in the key departments involved: Insurance, Medicaid and Community Based Services, formerly Social Services.
“I think it has been beneficial that I am a veteran,” she said. “They all know me. They all trust me. I have good working relationships with all of them. So I think that has helped to sell this.”
She said much credit should go to others. “We have just tremendous support from the business community, the Kentucky Chamber of Commerce … all of the medical related associations, advocacy groups, insurers, agents.”
But Banahan was key to making it happen, said her boss, Audrey Haynes, secretary of the Cabinet for Health and Family Services.
“There was not another person that was in this state as suited for that job at this time as Carrie Banahan,” she said. “And when I recommended her to the governor, he was also convinced that there was no one else.”
So far, more than 521,000 Kentuckians have enrolled for health-care coverage through Kynect, three fourths of them through Medicaid.
That was more than expected; when Banahan was interviewed this spring, her staff was celebrating with a cake for only 275,000 signups.
Banahan said her biggest surprise was “the overwhelming response, people applying. People out there on our website. That has been the biggest surprise for everybody, how successful the rollout was, the support we have had. It was a wonderful surprise.”
She added, “That just demonstrates that there was certainly pent-up demand from folks who needed affordable health insurance coverage… . There are people who couldn’t afford to get treatment and now they can seek services.”
Looking to the future, she said, “It will be hard to top next year.”
Banahan’s “next year” is closer than it sounds. She and her team are planning for the next open enrollments, which will run from Nov. 15, 2014, through Jan. 15, 2015.
She said her primary focus of the next enrollment period will be informing individuals about the subsidy component of Kynect, even those with private health insurance. A family of four making as much as $94,000 a year qualifies for a subsidy.
Kynect will also work on improving its Small Business Health Options Program (SHOP), which allows employers with fewer than 50 workers to enroll them for health coverage through Kynect; increasing outreach and education for those age 18-29, known as the “young invincibles;” and making sure people understand that the eligibility for Medicaid has expanded, and that many who qualify haven’t applied for it, Banahan said.
“I am always energized and very optimistic,” she said. “I am ready for the next open enrollment to see if we can reach more people.”