Kentucky's Republican governor is partnering with a former Democratic congressman to help implement the nation's first work requirements for Medicaid.
On Wednesday, Gov. Matt Bevin announced a partnership with the Foundation for a Healthy Kentucky, a nonpartisan health policy research group run by Ben Chandler.
Once the new work requirements take effect later this year, state officials predict Medicaid will cover 95,000 fewer people in five years, leading critics to accuse Bevin of taking away people's health insurance. Chandler said the foundation's goal will be to help Kentuckians keep their coverage.
"Our role is to help those Kentuckians who are eligible for Medicaid to meet the new waiver requirements," Chandler said, who was a representative from Kentucky's 6th Congressional district from 2004 to 2013. "Not at any time have any of these folks here suggested to us they are trying to throw people off Medicaid."
Medicaid is a joint federal and state health insurance program for poor and disabled people. Kentucky was one of 32 states that chose to expand their Medicaid programs under President Barack Obama's health care law. By including able-bodied adults with no children, Kentucky's Medicaid rolls swelled by more than 400,000 people. But the state still faces significant health problems, and Bevin and other Republican leaders say the program was too expensive to continue without changes.
In January, the Trump administration gave Kentucky permission to require adults between the ages of 19 and 64 to have at least 80 hours each month of "community engagement" to be eligible for Medicaid benefits. That includes working at a job, going to school, taking a job training course or community service. It was the first time the federal government had allowed a work requirement for Medicaid benefits.
Kentucky's new rules will begin July 1 in Campbell County, a northern Kentucky suburb of Cincinnati. They will expand to neighboring Kenton and Boone counties by September.
"The intent of this is to keep people covered either through their Medicaid benefits or move them to a better place where there is employer sponsored insurance," said Kristi Putnam, deputy secretary for the Kentucky Health and Family Services Cabinet. "We believe that is possible."
Chandler says the foundation will help people keep their coverage by offering work and volunteer opportunities for them to meet the new requirements. He also said the foundation will help some people pay their monthly premiums. To do this, the foundation will start a new entity, the Kentucky Health Engagement Foundation. Veronica Judy Cecil, an appointee under Bevin and former Democratic Gov. Steve Beshear, will lead that effort.
The foundation does not have a contract with the state, and no public money is involved in the deal. But Health and Family Services Cabinet Secretary Adam Meier and Education and Workforce Development Cabinet Secretary Derrick Ramsey sent the foundation a letter outlining the partnership.
"Many stakeholders have deep concerns about Medicaid-eligible beneficiaries losing their coverage. As do we. And we are committed to keeping as many people covered as possible," Chandler said.
Kentucky's work requirements have been challenged in federal court, but a judge has not issued a decision yet. Bevin has signed an executive order decreeing that if a judge ultimately blocks the new rules, he will eliminate the expanded Medicaid program because the state won't be able to afford it. State officials say they expect the new rules to save the state $300 million over five years.
Bevin has since backed off that estimate, saying the purpose of the program is not to save money but to make people healthier. He said Wednesday his goal is not to make Medicaid smaller. But he said Medicaid will shrink if the program is a success.
"As the population becomes healthier and becomes more engaged, becomes more active in the workforce, you will just by dent of that have fewer people involved in Medicaid. I'm convinced of that," he said. "It's a byproduct of everything we are trying to accomplish."