Kentucky became the first state with a work requirement for Medicaid, and now it has to do something arguably more daring: Build a mobile-friendly website that works.
This summer, the state will require many people who get taxpayer-funded health insurance to work or volunteer at least 80 hours a month. They hope nearly half a million people will use their smartphones to log their hours so the government can keep track of who is meeting the requirements.
It's the kind of government program that often draws disdain from small-government Republicans, but GOP Gov. Matt Bevin has embraced it as "a more efficient use of resources."
Government-run websites, however, are notorious for their glitches, including the disastrous federal rollout of HealthCare.gov in 2013.
Kentucky had its own problems in 2016 when a new system called "Benefind" — meant to consolidate all of the state's assistance programs — caused chaos when thousands of people received erroneous messages that their benefits had been canceled.
Kentucky officials said this time will be different. In January, they quietly began testing the new website with people who get food stamps. That federal program has similar work requirements in 20 Kentucky counties.
"It's gone extremely well, which is probably why you haven't heard of it," said Adam Meier, deputy chief of staff for Republican Gov. Matt Bevin who along with along with Kristi Putnam at the Department for Medicaid Services is overseeing the program's rollout.
Some health care advocates aren't so sure. The website is built by Deloitte, the same company that built Benefind.
"We all know that Benefind was a total train wreck," Democratic state Rep. Jim Wayne said. "I find it ironic that a governor who wants to cut red tape ... is now establishing all this red tape for working poor people and poor people with disabilities and poor people who are struggling to keep body and soul together."
Others worry that the state doesn't understand how some people use smartphones. Cara Stewart, of the Kentucky Equal Justice Center, said many of her clients do not have unlimited data and is worried they will have trouble logging their hours once their data is gone.
"I cannot figure out how this is purporting to make people healthier or a good use of resources," she said.
Meier said the state has had no problems with Deloitte. He estimated 80% of Medicaid recipients in Kentucky have a smartphone. While he hopes most people will use the website, he said people can also get help at the Department of Community Based Services, which has an office in every county. There they can get printed forms and mail them in.
Kayleeanna Hummell, an 18-year-old high school senior, said she will be Medicaid-eligible when she graduates this spring. She is just now learning about the work requirements, and said she's worried she will miss a step and lose her coverage.
"I'm definitely going to find a job," she said. "It's just the deadline thing is what scares me."
It's unclear how much the website and underlying technology will cost to build and maintain. Bevin first estimated it would save the state more than $300 million. But on Monday, Bevin told reporters the program "may arguably cost more."
"The intent isn't to try to save money from a budgetary standpoint," Bevin said.
Medicaid Commissioner Stephen Miller said the state has budgeted about $170 million to implement the Medicaid waiver, of which the state would pay $17.5 million. The federal government would pay the rest.
But Meier said that is an estimate, and state officials are "working to reassess" the cost.
In addition to tracking hours, officials said the website will let companies post job openings and nonprofit groups list volunteering options. And if someone does not log their hours, the state could send them a text message reminder.
"We're creating avenues and ways for people to be directed to the different opportunities that exist in the state already," Putnam said.
There are exemptions to the work requirement, including pregnant women, full-time students and others. Meier estimated between 100,000 and 130,000 will qualify for an exemption.