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January 11, 2018

Bevin's controversial plan to make Medicaid recipients work will get federal approval

Kentucky appears on the verge of winning approval for Gov. Matt Bevin's proposal to reshape the state's Medicaid plan after federal authorities announced Thursday that they will approve rules requiring some people on the government health plan to work or volunteer.Kentucky appears on the verge of winning approval for Gov. Matt Bevin's proposal to reshape the state's Medicaid plan after federal authorities announced Thursday that they will approve rules requiring some people on the government health plan to work or volunteer.

FRANKFORT, Ky. — Kentucky appears on the verge of winning approval for Gov. Matt Bevin's proposal to reshape the state's Medicaid plan after federal authorities announced Thursday that they will approve rules requiring some people on the government health plan to work or volunteer.

The U.S. Centers for Medicaid and Medicare Services (CMS) announced early Thursday it will authorize "community engagement" requirements that Kentucky and a half-dozen other states are seeking to impose on some people who get health coverage through the federal-state health plan.

Such rules, never before approved by the federal government, are a key part of Bevin's plan to reshape Medicaid in Kentucky.

It's been 16 months since Bevin first proposed a sweeping overhaul of the state's $10 billion Medicaid plan that gets about 80 percent of its funds from the federal government, which must approve it. Medicaid covers about 1.4 million people in Kentucky including poor children, adults, disabled individuals and elderly people in nursing homes.

Kentucky Medicaid Commissioner Stephen Miller said Thursday the decision by federal authorities is key to winning final approval for the Bevin's proposal known as Helping to Engage and Achieve Long Term Health, or Kentucky HEALTH.

“We are excited about the new guidance issued by CMS to allow states the flexibility to pursue innovative approaches to improve the health and well-being of Medicaid beneficiaries," Miller said. "This guidance is a critical step to moving the Kentucky HEALTH program forward."

But it was slammed by U.S. Rep. John Yarmuth, a Louisville Democrat who supports the current Medicaid program and its expansion under the Affordable Care Act that added coverage for nearly a half-million Kentuckians. He said the changes will force many to lose health coverage.

"My only hope is that the chaos caused by this policy and the desperation of the Kentucky families who will soon lose their only access to health coverage will force Gov. Bevin to demonstrate some level of compassion and reverse this disgraceful policy,” Yarmuth said.

Now that the work requirement has been approved, Miller said he expects "quick approval" of the state's proposal he said will help "Medicaid beneficiaries improve their social, educational, and health outcomes.”

Bevin's proposal would require some adults to work or volunteer at least 20 hours a week to keep health benefits, saying it will inject more personal responsibility into the government health plan and believes participants should have some "skin in the game."

But the requirements have been controversial with health advocates who say many people on Medicaid, a plan for low income or disabled people, already work at low wage jobs that don't come with health coverage. They argue that new restrictions and reporting requirements will cause many people to lose Medicaid health coverage.

Advocates say the work requirement and other changes will cause up to 95,000 Kentuckians to lose health coverage, according to the administration's own calculations.

Health advocates oppose many of Bevin's proposed changes as unnecessary obstacles to health coverage in Kentucky, a poor state which had one the sharpest declines in the nation of people with no health insurance after Medicaid expanded to include more people under the Affordable Care Act, or Obamacare.

In addition to work or volunteer requirements, Bevin's plan includes copayments and premiums from many participants. People who don't comply with rules could lose coverage and be "locked out" for months.

A statement by Kentucky Voices for Health, a coalition of health advocacy groups, said it is monitoring the latest developments closely and expects Bevin's plan, known as a "waiver" to be approved soon. The organization will "be following this process closely and will send out an analysis of the approved waiver when it is released," it said.

The Washington Post reports Kentucky's plan could be approved as soon as Friday. 

Advocates also say the work rules are likely to face a legal challenge since federal law establishes Medicaid strictly as a health plan for the poor and disabled with no requirements that some members work or volunteer.

Bevin's work requirement is aimed largely at "able-bodied" adults added to Medicaid under the Affordable Care Act and would exclude the elderly, disabled, medically frail or some caring for children or other relatives. The letter released Thursday by CMS authorizing work requirements contains similar language.

About 480,000 Kentuckians were added to Medicaid after the program was expanded under Obamacare to include anyone up to 138 percent of the federal poverty level, an annual income of $16,643 for an individual.

Health advocates and state officials across the country had been watching closely to see whether Kentucky would win approval for the work requirement.

The decision comes after the nation's top Medicaid official, Seema Verma, in a Nov. 7 speech to state Medicaid directors, said federal officials had decided to approve such work requirements for any state seeking them.

Verma, as a private consultant, helped design Kentucky's Medicaid waiver proposal before joining the Trump administration. CMS has said she would not be involved in reviewing Kentucky's application.

Verma also designed Indiana's Medicaid plan. That state also is seeking a work requirement.

By Deborah Yetter
Louisville Courier Journal

 

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Comments  

+1 #13 YUP 2018-01-16 13:35
Quoting Pointless:
Businesses won't hire people just so they can keep Medicaid. And if you get a job then you won't qualify. Once you don't qualify then you'll have to find either outrageously priced insurance or cheap insurance that doesn't cover [censored]. So then you are hit with tax penalties for not having insurance. No one wins with this but the state. The citizens will lose.

Welcome to working person's world. They may have insurance but is only a piece of paper. They don't pay anything anymore!!
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+1 #12 Joan 2018-01-15 17:24
Quoting School:
If the child is school age send them to school. They are specially trained and paid well to provide special education for your child. Contact the school where they will tell you exactly what services they offer.


Right because there are so many jobs especially around here that have a shift that u can hire into that will let you be home to send your child/children to school and be home to get them.
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+2 #11 Martha 2018-01-15 17:04
The rule would not apply to pregnant women, the chronically homeless or the "medically frail," which includes people with a substance-abuse disorder. So I can just get on drugs and I don’t have to worry about it?
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+2 #10 Obummer 2018-01-14 22:48
Obama really messed things up. Before the ACA, those that were normally able bodied but down on their luck could get medical assistance through programs that were sponsored by companies and organizations such as UK. Those programs are gone now and these people will be losing medicaid as well. Yes, some just don't want to work, but many are also down on their luck temporarily or maybe temporarily disabled and not eligible for disability. These people are going to suffer.
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0 #9 Lee 2018-01-14 13:46
This will be the next best thing to peanut butter and jelly!!! Put them out to work for their money. No car, no worries...There ’s garbage along the roads they live that needs to be picked up, brush that needs to be cut, ditches that needs to be dug. Just as the WPA created jobs so can this move by “my president and governor”. Make America Great again!!!!
The Works Progress Administration (WPA; renamed in 1939 as the Work Projects Administration) was the largest and most ambitious American New Deal agency, employing millions of people (mostly unskilled men) to carry out public works projects, including the construction of public buildings and roads.
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0 #8 Pointless 2018-01-13 22:26
Businesses won't hire people just so they can keep Medicaid. And if you get a job then you won't qualify. Once you don't qualify then you'll have to find either outrageously priced insurance or cheap insurance that doesn't cover [censored]. So then you are hit with tax penalties for not having insurance. No one wins with this but the state. The citizens will lose.
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+1 #7 Citizen 2018-01-13 19:29
Quoting School:
If the child is school age send them to school. They are specially trained and paid well to provide special education for your child. Contact the school where they will tell you exactly what services they offer.


The child is in school but we also do not use the school as a babysitter and these school systems are not set up for special needs. They say they are but they are not, you can say you train for it but You will never know until you are living with them. And there are certain levels of special needs, too...
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+1 #6 School 2018-01-12 17:31
If the child is school age send them to school. They are specially trained and paid well to provide special education for your child. Contact the school where they will tell you exactly what services they offer.
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0 #5 WORKING CITIZENS 2018-01-12 16:15
Quoting Citizen:
I understand not giving a free ride but when someone is taking care of a Special needs child and draws Medicare or Medicaid and cannot go to work then this will hurt this family badly. I just don't understand this at all. We are not dope heads or Alcoholics we are just good honest Americans from KY trying to live right.
I understand where you are coming from.Read this whole story again.It says able bodied people.It also say elderly.disable d and those caring for children.You should be okay.
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+3 #4 Ha Ha 2018-01-12 03:37
Boy this will clear them out. They will all move to WV where they can "Get on the draw". WV better build a wall.
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+4 #3 Wise Old Man 2018-01-12 01:39
I think this is a great idea. Too many for too long have sucked on the teet of the government rather than earn their own money, pay for their own health care etc. I wish every state would adopt this plan. Of course there are those like John Yarmuth, {mentioned in this article} whom will argue against this plan because many of his voters don't work and don't want to work. Too bad.
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+3 #2 WORKING CITIZENS!!! 2018-01-11 22:30
They should work for it If they are able to work. We work and pay for ours!!! Too many people in this world wanting free handouts!!!
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+2 #1 Citizen 2018-01-11 22:14
I understand not giving a free ride but when someone is taking care of a Special needs child and draws Medicare or Medicaid and cannot go to work then this will hurt this family badly. I just don't understand this at all. We are not dope heads or Alcoholics we are just good honest Americans from KY trying to live right.
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