Governor Matt Bevin announced federal approval of Kentucky’s Medicaid waiver on Jan. 12, 2018, making Kentucky the first state allowed by federal health officials to impose requirements for many of Kentucky’s Medicaid beneficiaries. The Kentucky HEALTH program will add premium payments and “community engagement” requirements for “able-bodied” Medicaid beneficiaries.
Bevin’s Kentucky HEALTH initiative requires those on Medicaid to either volunteer or work a part-time job in order to continue using Medicaid as their primary health insurance. However, Bevin’s Kentucky HEALTH initiative was struck down on June 29, 2018 by U.S. District Judge James E. Boasberg, calling the program run by Bevin’s administration “arbitrary and capricious.”
The Kentucky Medicaid program costs about $9.7 billion a year.
A month after Bevin’s waiver was denied, Bevin’s administration pulled the rug out from under many Kentucky Medicaid recipients in July 2018, stripping them of their vision and dental benefits that were formerly included in the state Medicaid program.
Afterward, in November 2018, the U.S. Centers for Medicare and Medicaid Services re-approved Bevin’s Medicaid waiver, albeit with minor changes made.
And now, the American Medical Association (AMA) and around a dozen other national groups representing doctors, hospitals, the elderly and the disabled are requesting that a federal judge again deny Bevin’s Medicaid eligibility standards for the Kentucky Medicaid program, which is set to begin April 1.
Sixteen Kentucky Medicaid recipients are in the process of suing the federal government due to Bevin’s “community engagement” requirements for Medicaid approval. Bevin’s waiver requires able-bodied Kentuckians to work 80 hours per month and pay insurance premiums. Other requirements include a six-month coverage lock-out period and monthly reporting duties, which would require recipients to make monthly check-ins with state officials.
Brian Hamby, director of marketing at Owensboro Health Regional Hospital said Medicaid patients who qualify for cost sharing have been required to make copayments as of Jan. 1, 2019.
“We understand that this policy has been communicated to all Kentucky Medicaid recipients,” Hamby said.
Hamby said the Kentucky HEALTH website doesn’t include an updated rollout schedule for the community engagement portion of the Kentucky HEALTH waiver set to begin on April 1. OHRH has a team of patient financial advocates, all of whom are certified application counselors and are able to guide patients through the process of applying for Medicaid coverage. In-person assistance is also available for those with questions about Kentucky HEALTH and can be reached by calling 1-855-459-6328. An assister in the local area will be able to meet up and discuss the upcoming changes required by the state, Hamby said.
According to Hamby, 18.5 percent of OHRH patients were Medicaid recipients in 2018.
“While the copay requirement will be a change for some of the Medicaid beneficiaries, Owensboro Health doesn’t believe it will present a barrier to care for our patients,” Hamby said.
The loss of dental and vision benefits for Kentucky Medicaid beneficiaries could very likely hurt those who previously took advantage of those services.
According to statistics from the United Health Foundation, oral health and vision benefits have been provided under the state Medicaid system since its inception in 2014. A Gallup survey claims that in the first year of Kentucky Medicaid’s existence, adult dental visits increased 116 percent between July 1, 2013 and June 30, 2104. Oral health is often directly linked to overall health, according to the American Health Rankings.
In 2018, Kentucky ranked 45th in overall health out of 50 states. Those numbers are expected to drop if thousands of Medicaid recipients are dropped from their insurance.
The Kentucky Cabinet for Health and Family Services Secretary Adam Meier said the state plans to follow through with the Kentucky HEALTH waiver, and hopes it will drive more Kentuckians to employment.
“The Kentucky Department for Medicaid Services will continue to work toward implementation of the Kentucky HEALTH waiver on April 1,” Meier said. “Kentuckians, and specifically our Medicaid members, deserve a Medicaid program that will improve health outcomes and provide paths for employability, long-term stability, and future success while also ensuring the long-term sustainability of Medicaid for those who need it most.”