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Bevin Official Tells Congress Kentucky’s New Medicaid System Will Be Streamlined

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A top advisor for Gov. Matt Bevin is revealing details on the new system that will help Medicaid enrollees track and meet almost all of Kentucky’s new requirements rolling out in July.

Adam Meier, Bevin’s Deputy Chief of Staff for Policy, spoke at a congressional hearing Thursday in Washington, D.C. about Kentucky’s plan to institute community engagement requirements for some Medicaid enrollees. Kentucky is the first state in the country to implement this kind of requirement.

Meier said at the hearing the state is building one streamlined system that will track the required 80 hours a month of community engagement, in addition to the program’s many other requirements.

“There’s one single sign-on for the members. They’ll also be able to do their My Rewards activities, do trainings like health and financial literacy for those classes, enter their community engagement hours, and it’s all mobile friendly,” Meier said. “Eighty percent of our members have a smart phone.”

In January, the federal government approved Kentucky’s Medicaid waiver, which changes the Medicaid program for some enrollees. The 80 hours a month of work, volunteering, training or education to keep Medicaid coverage will apply to enrollees who do not have a dependent, although some parents will also have to comply.

Parents may qualify for a “caregiver” exemption to this rule, but only one person per household will be exempt and the other will have to complete the engagement requirement.  Enrollees can also apply for an exemption if they have a chronic or disabling health condition, or are homeless.

Meier said Kentucky has many career centers to help residents find work, but until now the state has had no way to incentivize people to use those services.

“By engaging them in the community engagement requirement, it gives them the incentive to then connect with our career center and see all the resources that are available to them,” Meier said.

Since Medicaid was expanded under the Affordable Care Act, the program has offered health insurance coverage to Kentuckians making below 138 percent of the poverty line, and for people with disabilities. The new Medicaid waiver sifts people into new groups — based on their income, health status and whether they have dependents — and those groups will all have differing benefits and requirements to keep coverage.

Meier said his office does not have an official estimate on how much money the change to the Medicaid program will cost taxpayers. However, the state added $186 million to the current budget and is proposing $187 million in the next budget year to implement the Medicaid change, according to the Courier Journal. The majority of this cost, however, will be paid for by the federal government.

Meier said the remainder, $17 million, will be paid for through the savings from disbanding Kynect, the state-run exchange platform, as well as by putting aside additional funds in the proposed budget.

“Most of the implementation costs are being paid for out of savings from the move to Healthcare.gov and shutting down the state health care exchange,” Meier said. “We’re saving about $15 to $20 million a year by making that switch and we’re paying the state share based on those savings for the bulk of the implementation costs.”

Meier said the new system will also link people to the state’s child care assistance program, which provides financial help to families making up to 160 percent of the poverty line (about $3,240 for a family of three in a month).

© 2018 89.3 WFPL News Louisville. 

Lisa Gillespie is WFPL's Health and Innovation Reporter. Most recently, she was a reporter for Kaiser Health News. During her career, Gillespie has covered all things health — from Medicaid and Medicare payment policy and rural hospital closures to science funding and the dietary supplement market.
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