FRANKFORT, Ky. (KT) – Kentucky’s Medicaid waiver application has been approved by the Trump administration, making it the first state to require many of its Medicaid recipients to work to gain coverage.
Gov. Matt Bevin made the announcement that the Centers for Medicare and Medicaid Services gave the approval on Friday. The change will require adults between the ages of 19 and 64 to complete 80 hours per month of "community engagement" to keep their coverage. That includes getting a job, going to school, taking a job training course or community service.
Those under traditional Medicaid - the aged, blind and disabled - will not see any changes, but everyone else will.
Traditional Medicaid adults eligible prior to expansion will have no change in benefits, but will begin paying copays or premiums of $1-$15 per month and, except for those who are the primary caretaker of a dependent, will have to participate in the “community engagement.”
Medicaid expansion adults will have to pay premiums or a copay, community engagement will be required, and visual and dental coverage will be available through a My Rewards Account.
Pregnant women and children covered by traditional Medicaid and KCHIP will not have premiums or charges in benefits and won’t have to participate in community engagement.
Medically frail adults and former foster youth up to age 26 will keep their benefits and have optional premiums to access My Rewards, with no community engagement requirement.
My Rewards Accounts provides incentives for members to improve their health through preventative services and health education, community engagement and improve job skills.
“This is an extraordinary opportunity for us to chart a path that will produce the kind of results that are needed,” Bevin said during a Capitol press conference. “Kentucky will be better for it, Kentucky will be healthier for it, Kentucky will be more economically vibrant because of it, and Kentucky will continue to lead the nation.”
Bevin administration officials say this would affect about 350,000 Medicaid recipients, half of whom are already involved in community engagement. Currently, Medicaid costs the state $11 billion per year, according to the administration, and this could save $24 billion over five years.
Bevin said the program, with its emphasis on work and community service, will encourage healthier living.
"There is dignity associated with earning the value of something that you receive," Bevin said. "The vast majority of men and women, able-bodied men and women ... they want the dignity associated with being able to earn and have engagement."
There have been reports that a lawsuit could be filed against implementing Kentucky HEALTH and Bevin responded to that.
“It’s conceivable,” he said. “There are a lot of lawsuits that fly around this town and this country. People certainly have that right. We’ll see.”
Bevin described the program glowingly. “Good for the individual, it is good for the community, it is good for the workforce, it is good for the economy, it’s good for Kentucky and it’s good for America.”
He also told reporters that two other states have applied to do the same thing Kentucky is doing.
Reaction to the program has been mixed. Democrats, such as House Minority Leader Rocky Adkins, D-Sandy Hook, are opposed to it.
“Gov. Steve Beshear’s decision to expand Medicaid was a game-changer for Kentucky that has saved lives, improved our collective health and pumped billions of dollars into our economy,” he said. “The waiver approved today puts those gains at risk, ultimately removes needed healthcare for up to 100,000 Kentuckians and will almost certainly cost us more in the long run because of the added bureaucracy.”
Adkins said lawmakers need to hash out the program for its validity.
“The General Assembly needs to take a very close look at these changes and then decide if this is really the most productive course of action for the state to take for its citizens,” he said.
Republicans, such as House Speaker Pro Tem David Osborne, R-Prospect, expressed support.
“Medicaid expansion in Kentucky has not met our goals for improved health. Despite dedicated funding, we remain one of America’s most unhealthy states. Kentucky HEALTH is a course-change to realign our focus on the healthcare decision-making process, with resulting healthcare benefits. I’m excited about the possibilities presented by this fresh approach.”
Senate Majority Leader Mitch McConnell supported the changes, calling it "common-sense steps to engage patients, improve health, and reduce the burden on Kentucky taxpayers."