In Kentucky the protests have been about pensions, not pay, but the same Medicaid crowding out is taking place. The Bluegrass State was one of the first Medicaid expansion states under ObamaCare. Some 22% of residents—more than two million people—are enrolled. In 2008 Medicaid spending in Kentucky was $4.9 billion, but by 2017 it was $9.9 billion. The federal government paid $7.7 billion of that sum last year, but the burden has already begun shifting to states.
As for education, Kentucky’s public pension woes place it on par with New Jersey and Illinois, and teachers’ pensions are only 56% funded. Participants can draw full benefits as early as age 49, and some collect longer for more years than they’ve worked.
The Republicans who gained control of the Kentucky government in 2017 have made pension reform a priority. Legislation that passed in March leaves benefits untouched for retirees and current employees.
But it stops teachers from cashing in on accrued sick days at the end of their careers, a common strategy to game the system. And it shifts new hires to a hybrid retirement plan that operates more like a 401(k). The most optimistic estimates have the teachers’ pension running a $14 billion liability, and the changes make a dent of around $500 million to $800 million over 20 years.