Future of Medicaid expansion at risk in Kentucky

Wednesday, Kentucky Gov. Matt Bevin announced an ultimatum to the Centers for Medicare and Medicaid Services. The result could cost you your health care.

Bevin is asking for a section 1115 waiver to change the way Kentucky handles Medicaid expansion. If the federal government doesn’t agree to the terms, Bevin says it will be the end of Medicaid expansion in Kentucky.

Bevin told reporters Wednesday morning he wants people to be more accountable for their coverage by charging them a small premium instead of a deductible. His proposal would mean $1-$15 a month, depending on an individual’s income.

Those who fall between 24 and 138 percent of the national poverty level will still qualify for coverage. For example, a family of three would need to make between $6,854.40 and $27,820.80 to qualify for Medicaid coverage. “Ultimately, we want people to be on private insurance, because they’re working, because they’re involved in their communities, and they are engaged as employees in companies where this is available to them,” Bevin said.

If you’re on expanded Medicaid right now and work somewhere that offers coverage, you will have to switch to your employer’s coverage after one year. Bevin wants to take out emergency transportation coverage as well as dental and vision. But, through volunteering in their communities, Bevin says people would be able to earn dental and vision rewards. “We want people to take ownership, because there is dignity that comes with that. And we are robbing people the ability to do for themselves.”

After two years under Bevin’s changes, your premiums would go up if you’re above the poverty level.

Bevin says he believes the new plan will save $2.2 billion in federal money in five years and more than $300 million in state money.

Former governor and supporter of Medicaid expansion Steve Beshear disagrees. He released a statement that says, in part: “It is up to Gov. Bevin himself to decide whether to terminate expansion, not the federal government and the accountability for that decision will lie on his shoulders. Our families deserve better than these petty threats.”

The Kentucky House Republican Caucus release a statement saying: “The individual buy-in is the right direction. Kentucky must focus on results-driven health and a cost sharing approach, rather than the continues reliance on taxpayer funded benefits."

U.S. Senate Majority Leader Mitch McConnell had this to say in after the news: “I applaud Gov. Bevin for recognizing the unaffordable mess left behind by his predecessor and responding with innovative, common-sense steps to engage patients, improve health, and reduce the burden on Kentucky taxpayers.”

The final proposal will be sent to the Center for Medicare and Medicaid services after three public hearings in Kentucky by Aug. 1. Bevin hopes to have an answer by Sept. 30.

Public Hearings

  1. West Kentucky University, from 10 a.m. to 12 p.m. on June 28 in the Knicely Conference Center Auditorium in Bowling Green. 
  2. Advisory Council for Medical Assistance (MAC) special meeting from 1 p.m. to 2 p.m. on June 29 in the Kentucky Capitol Annex in Frankfort.
  3. Hazard Community and Technical College Campus in Hazard from 11 a.m. to 1 p.m. on July 6 in room 208.

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