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June 21, 2018

Kentucky’s Medicaid program covers about 1.4 million low income or disabled individuals

 

FRANKFORT – Health coverage for up to half a million poor Kentuckians could be cut back or eliminated altogether if a federal judge blocks the state from enacting work requirements and other changes aimed at some people covered by Medicaid, the state’s top human services official said Wednesday.

Adam Meier, secretary of the Cabinet for Health and Family Services, told a legislative committee that the state may have to make cuts to offset a budget shortfall in Kentucky’s Medicaid program that covers about 1.4 million low income or disabled individuals.

Those most likely to be affected by such cuts are about 500,000 Kentuckians added to Medicaid since 2014 under an expansion allowed by the Affordable Care Act.

On Friday, U.S. District Judge James E. Boasberg in Washington, D.C., held a hearing on a legal challenge to Kentucky’s plan and said he hopes to issue a ruling before July 1 – the day Kentucky plans to launch the changes championed by Gov. Matt Bevin.

Health law advocates filed a lawsuit challenging Bevin’s plan on behalf of 16 low-income Kentuckians who say they would be harmed by the changes. Lawyers for the National Health Law Program, the Southern Poverty Law Center and the Kentucky Equal Justice Center are handling the case.

A court ruling forcing Kentucky to postpone the changes could worsen the budget problem, even if the ruling is temporary, said Meier, who spoke to the joint House-Senate Health and Welfare and Family Services Committee.

“I think we’ll just have to look and see what the budget situation is,” Meier said in an interview after the meeting. “We hope there’s no interruption.”

Meier said any delay would be disruptive, since his cabinet has begun notifying people of the pending changes, how they will be affected and what they must do to comply.

“It means there’s going to be a lot of confusion,” he said.
Bevin, a Republican, has said if a court issues a final ruling blocking his changes under a “waiver” from the federal government, he would terminate the expansion authorized by his predecessor, Democrat Steve Beshear.

Jeremy Learning, communications director for the health law program, said that would only hurt Kentucky.

 

 

“In all states that have expanded Medicaid, the evidence is overwhelming that expansion of Medicaid – paid largely by the federal government – is sharply bringing state health care costs down,” he said. “Bevin’s tired threat to roll back Medicaid expansion if a federal court invalidates Kentucky’s Medicaid waiver scheme reflects an ideological desire to destroy Medicaid, a public program to provide health care to people and families who cannot afford to access the private health care insurance system.”

Meier said the state expects to save money in the state’s $11 billion-a-year Medicaid program through Bevin’s changes, though he couldn’t say yet how much.

If a judge delays the changes, the state will have to find savings elsewhere, Meier said. Meier said in a separate report to the legislative Medicaid Oversight Committee that the state projects a shortfall of about $300 million in Medicaid over the next two budget years.

 

{ At the least, the state likely would have to reduce benefits such as dental, vision and possibly prescription drug coverage for some people, primarily those added since 2014 under the Medicaid expansion, Meier said. }

 

Or, he said, the state could eliminate coverage for the about 500,000 people added under the federal law that permits states to expand Medicaid to anyone at or below 138 percent of the poverty level, an annual income of about $16,400 a year for a single adult.

Under Bevin’s proposed changes, dental and vision care would be eliminated for such adults though they could earn points to buy such services through a “My Rewards” program. They also would be required to pay small monthly premiums or face a potential lockout of coverage.

The primary legal challenge is to the efforts of Bevin and officials in about a dozen other states to enact “community engagement” rules that would require “able-bodied” adults to work, volunteer or attend school at least 20 hours a week. In January, Kentucky became the first state in the nation to win approval from the Trump administration for the work requirements.

Opponents say the work rules are unnecessary because most adults covered through the expansion already work, largely at low-wage or part-time jobs that don’t include health coverage. In court last week, they also argued that federal law doesn’t permit work requirements because Medicaid is a government health plan, not a jobs program.
Bevin already has proposed eliminating the expansion of Medicaid if Kentucky loses the court fight.

In January, when Bevin announced the Trump administration had approved his plans to reshape Medicaid, he issued an executive order calling for the expansion to be dismantled should there be a final court decision blocking his plans.

Bevin has criticized the expansion enacted by his predecessor, Democrat Steve Beshear, as too costly and too generous. But any savings from Bevin’s changes would come largely by eliminating nearly 100,000 people from Medicaid over the next five years, according to the state’s projections.

Under the changes, the state will actually spend more money on Medicaid coverage than it would had it done nothing, according to the state’s projections. Officials say the goal is to get more people to work and onto employer health plans.

Meanwhile, the state projects it will spend more than $300 million over the next two years to upgrade its computer systems to handle the changes.

Meier said Wednesday that the state wants to create “a path to success” for individuals on Medicaid, “We want to get them a job, a better job and a career,” he said.

By Deborah Yetter
Louisville Courier Journal

 

 

Comments  

0 #3 johnnie 2018-06-23 18:40
Too many able to work, and don't want to.

...never had to get up early, sleep till noon.
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0 #2 concerned 2018-06-23 14:34
What about the people who draws monthly social security checks? We hardly have enough coming in each month to pay the most important bills no money left for food, etc. Government hollers honey u draw too much, tell me how r we suppose to volunteer if u can't afford the gas to get there on? Then people comes from another state they go into the office get things handed to them and they don't have to do anything like this. That's not right...!!!
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0 #1 Concerned 2018-06-22 18:53
Leave it as it is
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