Kentucky HEALTH set to roll out soon as administration tracks court challenge

06/19/2018 07:29 PM

Kentucky is just weeks away from implementing a first of its kind work requirement for some Medicaid recipients in the Commonwealth, and Cabinet for Health and Family Services Secretary Adam Meier, hopes the nation witnesses a smart and thoughtful implementation of the Kentucky HEALTH plan.

The plan is a first of its kind innovation waiver approved by the federal government, but before the first Medicaid recipients in the state see any changes the waiver is being challenged in court. A judge is set to decide the waiver’s fate, and Meier says he feels the waiver is consistent with goals of Medicaid, but if a judge disagrees there’s several contingencies.

The Bevin administration would expect to challenge any ruling against the waiver through the courts, but if it failed the decisions get tough quickly, Meier said.

“What that’s likely to result in is removal of dental and vision benefits, potentially pharmacy benefits from the adult eligibility group – the low income adult eligibility group,” he said.

An adverse ruling could also cause the full scale rollback of expanded Medicaid, which took place under former Gov. Steve Beshear, D-Kentucky. Ending expanded Medicaid has been both a campaign promise and threat from Gov. Matt Bevin, R-Kentucky.

The judge is set to decide that case before the first counties see changes on July 1.

The changes to Medicaid will begin in Northern Kentucky, and will continue through 2018.

Kristi Putnam, the deputy secretary of the Cabinet for Health and Family Services, says the waiver is modeled after private insurance, and includes a deductible account to help those in the system get familiar with their care, and how private insurance works in the hopes they will eventually transition their care.

The waiver also includes a My Rewards account where recipients “earn virtual dollars” through preventive services, online education, participating in healthy activity. Those dollars can be used for routine dental and vision care under the new plan.

One component that is garnering a lot of attention is the community engagement component, which Putnam says is very specifically not called a work requirement, because they hope to engage the community in the benefit of others.

Non-disabled Kentuckians on Medicaid be denied coverage for not meeting the requirements of community engagement.

Putnam said that the cabinet is not intending to “kick people off or transition people out” unless it’s a positive transition for the individual.

“We would like to see people transition from public assistance into a private market insurance so that their quality of life long term they have healthier outcomes, they have better networks, and they have better opportunities long term,” Putnam said.

Watch the full interview, including what the plan could cost, and what Meier said Medicaid should be used for in the video below.

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