Special to NKyTribune
The Foundation for a Healthy Kentucky
Governor Bevin released the Kentucky HEALTH proposal, aimed at modifying Kentucky’s Medicaid program, on June 22. This proposal would make significant changes to Kentucky’s Medicaid program. Following federal guidelines, there will be two comment periods during which the public may provide input on these proposed changes. The first comment period, June 22 through July 22, is specifically for Kentuckians to provide comments on the many provisions of this proposal.
The Foundation for a Healthy Kentucky encourages Kentuckians to learn about these proposed changes to Medicaid and provide input at one of the three public hearings and via email or letters (details below). A second comment period will be scheduled after Kentucky submits the proposal, which may be revised to reflect initial comments, to the federal government for approval.
Components of the Medicaid 1115 waiver proposal include:
1 Modification to covered smoking cessation and substance use treatment options
2 Dental and vision care no longer included in the core Medicaid benefits package
3 Incentives for actions such as health risk assessments and smoking cessation
4 Medicaid enrollees will be required to pay premiums, on a sliding scale:
5 Kentucky HEALTH will require, incentivize and reward members who engage in their community through volunteer efforts, job training, or employment. Hours required depend on how long Medicaid members have been enrolled in Medicaid:
◦ 1-3 months: 0 hours per week
◦ 4-6 months: 5 hours per week
◦ 6-9 months: 10 hours per week
◦ 9-12 months: 15 hours per week
◦ 12+ months: 20 hours per week
6. Employer premium assistance program: Kentucky HEALTH members who currently have access to health insurance through their employer will have the option to enroll their family into their employer-sponsored health insurance. Participation in premium assistance is optional during their first year of enrollment, but mandatory after the member’s second year of eligibility, provided the member has been employed with their employer at least one year.
You can read the Foundation’s initial statement on the proposal here. Other resources on Medicaid 1115 waivers:
• Report on input provided by diverse Kentucky stakeholders on reforming Medicaid (prior to the proposal being released), here
• Background on what other states have done to reform their Medicaid programs, here
• Other links and resources on Medicaid 1115 waivers, here
You can read the key proposal points here.
Frequently asked questions, from the Kentucky Cabinet for Health and Family Services
For the full proposal, click here.
Public comment opportunities:
Written comments regarding the Kentucky HEALTH waiver proposal may be mailed to:
Commissioner Stephen Miller
Department for Medicaid Services
275 E. Main Street
Frankfort, KY 40621
or sent by email at kyhealth@ky.gov
All comments must be received by Friday, July 22, 2016 at 5 p.m. Eastern time.
In addition, the Commonwealth will conduct three separate formal public hearings at the following dates and times:
► Public Hearing 1– Tuesday, June 28, 2016, 10 a.m. – noon Central time
Western Kentucky University-Knicely Conference Center Auditorium
2355 Nashville Road
Bowling Green, KY 42101
► Public Hearing 2: Advisory Council for Medical Assistance (MAC) Special Meeting – Wednesday, June 29, 2016, 1 p.m. – 2 p.m. Eastern time
Kentucky Capitol Annex
702 Capital Avenue
Frankfort, KY 40601
► Public Hearing 3 – Wednesday, July 6, 2016, 11 a.m. – 1 p.m. Eastern time
Hazard Community and Technical College Campus
Room 208, Jolly Classroom Center
1 Community College Drive
Hazard, KY 41701
From Foundation for a Healthy Kentucky
The real kicker in all this is the $1000 deductible.
Exactly how are the homeless, those working a part time job or a full time minimum wage job supposed to afford the $1000 before their insurance even starts? The ACA set a guideline so that people would no longer be forced to choose between paying for food and shelter and going to the doctor. Bevin’s plan would return the poor back to those days.
The largest group living under the poverty level are those with disabilities (One third of those under the poverty level are disabled), many of whom are not covered by Social Security. They have a harder time finding employment and housing. And Bevin’s plan would hit them the hardest. Given that the disabled already have a harder time finding employment, where are these jobs he expects them to obtain? If they can’t afford their insulin, or their epileptic medication or their asthma medication, how do they obtain and keep a high enough paying job to afford to pay the deductible? How do they do a job if they need glasses to see?
Studies have shown that the higher someone’s deductible, the less likely they are to go to the doctor and that waiting to go to the doctor causes people to wait until medical issues are more deadly. The easier that it is for people to get preventative care, the better the medical outcome.
This isn’t a medical plan comparable to the ACA, this is more an illusion of having insurance without actually having insurance available.