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Government & Politics

(Update) Gov. Bevin Submits Revised 'Kentucky HEALTH' Medicaid Plan

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Afternoon Update: Responses from Kentucky Youth Advocates, Save Kentucky Healthcare and Congressman John Yarmuth.

Governor Matt Bevin says he has changed his proposal to overhaul the state's Medicaid program and submitted it to the federal government for approval.

The new proposal called Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) will cover allergy testing and private duty nursing for about 400,000 Kentuckians who have health insurance through the state's expanded Medicaid program under the federal Affordable Care Act.

People who are in hospice care, have HIV or AIDS and receive federal disability benefits will also not have to pay premiums or copays. The elimination of automatic dental and vision benefits will be delayed by three months.

People can still get those benefits by earning credits in a ‘My Rewards Account’ by doing things like earning a GED and having a health assessment.

Bevin said his administration received nearly 1,350 public comments on the proposal.

CMS has 15 days to acknowledge the waiver has been submitted. There will then be a 30 day federal comment period, after which the Secretary of Health and Human Services has authority to approve the waiver.

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Per a news release here are some of the changes listed:

Highlights of those changes include:

  • In response to the topic that received the most comments by far: allergy testing and private duty nursing will continue to be covered services.
  • The implementation of changes to the dental and vision benefit will be delayed by three months to allow members additional time to accrue funds in their My Rewards Account.
  • Individuals determined “medically frail” will be exempt from required premiums and copayments.
  • GED testing costs will be added as an additional covered benefit for Kentucky HEALTH members.
  • The list of activities resulting in contributions to the My Rewards Account will be expanded to include caretaking responsibilities, passing the GED and ensuring children receive recommended preventative services, like immunizations. 
  • Sliding scale premiums will be collected on a household basis (not individual basis).

In addition, several existing policies were clarified to address misconceptions in the public comments:

  • Benefits will not change for children, pregnant women, medically frail and adults eligible for Medicaid before expansion.
  • Full-time students or individuals working more than 20 hours per week are already meeting the community engagement and employment requirements.
  • Smoking cessation benefits are not reduced under the waiver.
  • Disabled individuals receiving waivers or SSI will not be impacted by the waiver.

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Response from Kentucky Youth Advocates:

In a response by Kentucky Youth Advocates, Dr. Terry Brooks said while they appreciate the modifications, they still have some concerns. The new plan does not include former foster youth up to the age of 26 in the waiver and options to gain rewards through activities (like a parent taking a child to the doctor) - both were changes they advocated. Their concerns include low income individuals still subject to copayments and premiums they cannot afford, that individuals without job growth potential not able to pay increasing monthly premiums and that vision and dental services are considered an 'earned benefit.' Kentucky Youth Advocates is a nonprofit children's advocacy organization.

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Statement from Save Kentucky Healthcare:

"Today the Bevin Administration submitted its Kentucky HEALTH waiver proposal to the Dept. of Health and Human Services. The proposal contains a work requirement and imposes premiums on very low-income individuals, two conditions that HHS has said it would not approve. By submitting this waiver proposal, which threatens to move Kentucky’s nation-leading progress in health backwards, Gov. Bevin is putting his own political ideology ahead of the health and well being of hundreds of thousands of Kentuckians."

Save Kentucky Healthcare is a health advocacy effort led by former Kentucky Governor Steve Beshear.

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Statement from Democratic Congressman John Yarmuth:

"Governor Bevin has submitted a Medicaid waiver proposal that the Federal government legally cannot approve. Once they deny it, he will terminate our Medicaid expansion and attempt to blame President Obama when Kentucky families lose their coverage. I strongly oppose the Governor's shortsighted waiver request and, given the serious consequences for hundreds of thousands of Kentucky families, I'm not surprised he lacks the courage to be upfront about it."

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