As a member of the Kentucky House of Representatives, a R.N., and a retired health care administrator, I wanted to carefully review the Kentucky HEALTH proposal, the Medicaid waiver, and fully understand the elements of the plan: the cost analysis, projection, and health benefits before commenting.
In a state of just 4.3 million citizens, we should all find it alarming that in the last decade, those enrolled in Kentucky’s Medicaid program has more than doubled from 600,000 Medicaid enrollees to just under 1.4 million Kentucky citizens!
We have some huge challenges before us.
Two weeks ago during the Appropriations and Revenue Interim Joint Committee Meeting, Secretary Brinkman and members of the Health and Family Services Cabinet presented an overview of the recently unveiled initiative to reshape Kentucky Medicaid, including the components of the proposed waiver known as Kentucky HEALTH, which will soon be submitted to the federal government. During the presentation, Committee members had the opportunity to engage in discussions on Medicaid enrollment, utilization, cost, future projections, and statistical information.
As I followed the criticisms and judgments since the Administration announced Kentucky HEALTH, I think this is one of those situations when a sensitive issue is touched, like health care for the disadvantaged, and everyone immediately retreats to a defensive position, often hearing only what they are expecting to hear. What fails to be reported and seems to get missed are many of the actuarial facts.
Rep. Addia Wuchner
For instance, Kentucky’s Managed Care Organizations (MCOs) are paid more and their average profits are greater than any other state in the nation. Governor Bevin’s Administration has already taken steps to correct this issue, renegotiating the contracts to ensure a more prudent use of taxpayers’ money. A savings of over $280 million is projected over the next six months. It will also ensure that more Medicaid dollars go to providing actual health care benefits to Medicaid recipients rather than MCO profits.
These are very complex matters, and after review, I believe the Administration has taken not just a dollars- and cents-approach, but a compassionate and common-sense approach, raising necessary questions that examine several problems with the current Medicaid program.
For example, are we leveraging state and federal dollars in the most cost-effective and responsible way? By providing government fully funded Medicaid to the able-bodied population, are we preserving sufficient resources to serve the most vulnerable Kentuckians: children, the aging, the blind, individuals with disabilities, and those most in need? Are we aligning our health policy and incentives with the desired outcomes — because truth be known, despite plenty of spending, we have not effectively moved the needle on improving health outcomes in Kentucky.
And how do we proactively assist Kentuckians to obtain health care coverage while at the same time ensure such assistance includes a path to independence and advances their potential, rather than binding our citizens in the cycle of dependency?
Kentucky HEALTH is not only fiscally responsible, but also reflects a keen understanding of how we should view our fellow citizens who are Medicaid-eligible. Over time, our well-meaning charity and compassion has robbed many able-bodied individuals of their capacity and productivity and driven them deeper into a life of dependence. It is actually “toxic charity” and insulting to individuals’ human dignity when we continue to think that Medicaid-eligible citizens are incapable of engaging in their own health care and taking actions to improve their well-being and health outcomes.
Kentucky HEALTH does not kick current recipients off of Medicaid, but it does require able-bodied individuals to engage in their community and themselves to earn additional benefits over the standard benefit package through activities such as community service, working on their GED, or job training.
Many of the proposed Kentucky HEALTH initiatives and incentives that encourage individual health care responsibility and improved well-being are the very same ones that were incorporated into the private and public employee insurance and health care plans over a decade ago. Why would we NOT want the same benefits, with proven outcomes, for our Medicaid-eligible citizens?
The proposed waiver and changes incorporated in the Kentucky HEALTH plan will preserve Kentucky taxpayers’ dollars and ensure health care for our most vulnerable citizens and the uninsured–but it doesn’t stop there. Kentucky HEALTH provides for our able-bodied Medicaid recipients to also become informed and responsible health care consumers and provides them an opportunity to improve their lives and rise out of the welfare trap.
The time has come for a principled and fiscally responsible approach to improving the lives of all our citizens—an approach that incorporates dollar and cents as well as compassion and common sense. Governor Bevin’s Kentucky HEALTH plan does exactly that.
Addia Kathryn Wuchner is an R.N. and state Representative and vice chair of the House Health and Welfare Committee. She is originally from Louisville, resides in Boone County, and serves the people of the 66th House District. She former Vice President of Strategic Planning for St. Luke Hospital and The Health Alliance, and Founder/Director of Project Wings of Mercy – Hope and Humanitarian Aid Medical Missions.
Ms. Wuchner states in her second paragraph “In a state of just 4.3 million citizens, we should all find it alarming that in the last decade, those enrolled in Kentucky’s Medicaid program has more than doubled from 600,000 Medicaid enrollees to just under 1.4 million Kentucky citizens!” No, Ms. Wuchner, we should be alarmed that we have so many poor people in the state. Health insurance is a good thing and should be encouraged. In defending the Governor’s Kentucky HEALTH program, you are doing a great disservice to all those poor people who are just trying to hang on but I suppose that poor people don’t live in your district so it won’t matter at election time. Rep. Yarmuth opined and it is becoming widely believed, that the Governor loaded up the new plan with so many poison pills that the Feds will never approve it. He can then cancel expanded Medicade completely thereby fulfilling a campaign promise and blame it all on Obama. By the next time he has to campaign, all those voters who lost their insurance will be either dead, blind or too incapacitated to find a poll.
Wuchner’s piece is long on opinion; short on facts. It would pass as chamber floor speech but not as journalism. The Tribune ought to label pieces like this as opinion pieces.
Mr. Thomas: Rep. Wuchner is a state legislator and an experienced registered nurse. Her commentary appeared in our “Voices” section, which is where opinion and commentary are placed, clearly signaling that the content represents the “Voice” of the person writing it. It is clearly credited to the writer. The bios at the end of the commentaries identify the writer. That section contains a variety of opinions and points of view and is open to any and all citizens who wish to weigh in — through letters to the editor or “op ed” pieces or columns/commentary. It is not presented as journalism but as free speech, and we are pleased to offer the forum.
“Over time, our well-meaning charity and compassion has robbed many able-bodied individuals of their capacity and productivity and driven them deeper into a life of dependence. It is actually “toxic charity” and insulting to individuals’ human dignity when we continue to think that Medicaid-eligible citizens are incapable of engaging in their own health care and taking actions to improve their well-being and health outcomes.
Kentucky HEALTH does not kick current recipients off of Medicaid, but it does require able-bodied individuals to engage in their community….”
This is truly good work Representative Wuchner. Truer words were never spoken.The hard working taxpayers really appreciate you. It is unfortunate that so many people understand the government help to be an entitlement.
Compassionate?
How compassionate is it to say that even though an individual qualifies for medical assistance that if their health deteriorates to the point that they need nursing home care, they have to pay the first month’s expenses. (The average nursing home costs $3,000/month) We’re talking about individuals under the poverty level. The plan creates a catch-22 where a person needing nursing home care can’t get nursing home care because they can’t afford the first month.
How compassionate is it to tell a deaf person that they need to get a job in order to get a hearing aid? How are they supposed to hear the questions at the interview?
In our rural counties that have no transit services, this plan cuts the medical transportation service people counted on to get to doctors appointments. How does this help get people healthier if they can’t to their physicians? How is it compassionate to do this?
The plan wants people to go to work but fails to address the continued issue of low paying jobs that can’t raise people out of poverty and businesses that get assistance from the state while hiring people part time so that they don’t have to pay benefits. It also fails to address the fact that while it demands people obtain training and career assistance, it fails to mention that career assistance through the state in offices like the OVR are being cut. This is something that Rep. Wuchner would know, had she cared to do her research.
This plan has neither compassion nor empathy for the poor in Kentucky nor understanding of how poverty or medical assistance works. If this plan is enacted, individuals with disabilities and people with serious health issues will fall through the cracks and will die because they cannot jump through the hoops this administration has created. And there is no compassion in that.
To the Byrnes: Regardless of any merit of your argument; The Feds will not approve our accidental Governor’s plan, he will cancel Medicaid for thousands of Kentucky citizens; He will have fulfilled a campaign promise to the teapartiers and it will be Obama’s fault.
Rene Thompson: Nothing is keeping you from using all your personal resources to help poor people. The taxpayers are already paying more than enough. What bothers me is the increasing cost of all this where the average taxpayer has to pay more and more. Most people can afford to pay at least something towards their health care.