Lawmakers express caution over future of expanded Medicaid program

07/24/2014 04:39 PM

While Medicaid expansion in Kentucky as part of the Affordable Care Act is looked at by some as a success story around the country, state lawmakers were a bit more reserved in praising the expansion at the Interim Joint Committee on Appropriations and Revenue meeting on Thursday.

Lawrence Kissner, Commissioner of the Department of Medicaid Services told committee members that an independent study by the University of Louisville’s Urban Institute found that expanding Medicaid has been beneficial for the state in several areas including 17,000 new jobs, mostly in the health related field, $11 billion funding to providers for the next 7 fiscal years and $800 million in savings for Kentucky over that same length of time.

Kissner also touted the health care outcomes improvements for Kentuckians from FY 2013 to 2014 which include the following:

-Annual Dental Visits increased member utilization by +15.8%
-Adult Preventative Services increased by +36.7%
-Breast cancer screening increased +20.6%
-Cervical cancer screening increased +3%
-Colorectal cancer screening increased +16.1%

However, some lawmakers expressed concern about how to truly evaluate the success or failure of the program.

One concern was the projected expense of the Medicaid program, once the state has to start help fund the program beginning in 2016.

Sen. Chris McDaniel, R-Taylor Mill, asked Kissner what the projected cost to the state will be when the state has to contributing 3% in 2016 and then climbing gradually up to 10% in subsequent years.

“I don’t have those numbers,” said Kissner. “We know what we’re spending now. We’re spending $1.5 billion right now in benefit increases at the state level.”

McDaniel expressed concern that there isn’t a solid number as to what the cost will be.

Sen. David Givens, R-Greensburg, was concerned about what yardstick is used to measure how successful things are going.

“What sort of markers of success do we need to be looking at,” Givens asked Kissner.

Kissner also cited 983 new providers added by the Department of Medicaid Services which include 352 licensed professional clinical counselors, 397 clinical social workers, 96 licensed marriage and family therapists, 25 licensed psychological practitioners and 102 licensed psychologists and 31 behavioral health multi-specialty groups.

Kissner told legislators that Medicaid expansion has not been static by dynamic, stating that the individuals making up that enrollment are constantly changing.

Only 81% of the individuals enrolled in June of 2012 were still enrolled in June of 2013. Only 70% of members were enrolled in all 3 years.


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