How to fix Medicaid in Kentucky? Shrink it, lawmaker says

06/12/2013 05:09 PM

The way to untangle Kentucky’s problems with Medicaid managed care — and save the state money — would be to shrink the program and, instead, help many current Medicaid recipients pay for private insurance, a GOP lawmaker suggested.

Rep. Robert Benvenuti, a Lexington Republican and former inspector general of the Health and Family Services Cabinet, said the biggest problem facing Medicaid is not the managed care companies but the structure of the entire program.

“Managed care should not be, ‘We’re going to cut the legs out from under our providers,’” Benvenuti said.

Legislators on the Program Review and Investigations Committee on Thursday will question top-ranking state Medicaid Department officials on the progress of managed care. It’s unlikely legislators will grill Medicaid Commissioner Lawrence Kissner about that specific topic. But Kissner and the Health and Family Services Cabinet continue to take heat from legislators over the agency’s ability to referee disputes between providers (doctors and hospitals) and the managed care companies hired by the state to hold down Medicaid costs.

Benvenuti said Medicaid should pay the full freight for the most severely disabled and the very sick who have no other way of paying health bills. Beyond that, low income Kentuckians should have to pay nominal co-pays of a few dollars when they go to the doctor or hospital so they have some skin in the game, he said.

“You means test and subsidize outside of that” by helping low-income Kentuckians pay for private insurance, Benvenuti said.

He said such a system could save money long-term by adding more incentives much like car insurance.

“If you’re drug-free, if you’re in health education classes, etc., we’ll have a diminishing program where those premium payments and those co-pays will lower. Your already modest co-pay, you can lower it even more,” he said (2:30).

Benvenuti also endorsed a proposal to require drug tests for those who seek public assistance like Medicaid. (3:00)


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