Legislators get update on summary of changes to Kentucky HEALTH 1115 Medicaid Waiver

07/17/2017 05:22 PM

FRANKFORT – A summary of changes to the Kentucky HEALTH 1115 Medicaid waiver was presented to members of the Interim Joint Committee on Health and Welfare and Family Services on Monday.

The plan would impose stricter work requirements for Medicaid beneficiaries than originally requested, requiring able-bodied adults without dependents to work at least 20 hours a week to qualify for coverage.

The 20-hour requirement would start as soon as the waiver is approved.

It’s estimated the the new waivers would save the state $338 million over five years in running the Medicaid program, which is financed jointly by the federal and state government.

Kristi Putnam, Project Manager for the Cabinet for Health and Family Services, pointed out to committee members the populations which would see no changes in their current benefits with the new proposal.

“That would include traditional Medicaid, the aged, blind and disabled populations, former foster youth up to age 26,” Putnam said.

Medicaid populations included in Kentucky HEALTH are non-disabled adults and children including individuals covered before expansion, pregnant women, children, and the adult expansion population.

Pregnant women and children, and medically frail adults would see no changes in benefits, while traditional Medicaid adults prior to expansion would be required to do community service hours to get dental and vision through the MCO. Medicaid Expansion adults would be subject to community engagement unless they are a primary caretaker of dependent.

Adam Meier, Chief of Staff for Policy of the Office of the Governor, pointed out that modification to the community engagement hours was proposed to avoid confusion for members. It aligns the community engagement hours with the Supplemental Nutrition Assistance Program (SNAP) requirements for non-exempt individuals.

The original waiver had a graduated hours requirement beginning at 0 hours per week for the first 3 months, 5 hours per week for 4 – 6 months, 10 hours per week for 7-9 months, 15 hours for 10 – 12 months and 20 hours per week for 13+ months.

The proposed modification would be 0 hours for months 1 -3, and 20 hours per week for any time after.

“Between the feedback we got and the complexity of communicating those requirements to members and building those capabilities into the IT systems, we thought it was prudent to move it to a static requirement that would match the SNAP policy,” Meier said.

A controversial modification includes a six-month lock-out of benefits for failure to report a change in circumstance.

“Timely and accurate member reporting of information is crucial to the successful implementation of Kentucky Health,” Meier said. “Even if a member enters a lock-out period, early re-entry will be offered through completing a Health Literacy for Financial Literacy course and obtaining an updated certification of eligibility.”

The last modification calls for maintaining Current Presumptive Eligibility, as it was determined that in developing the PE requirements for Kentucky HEALTH, such expansion would be operationally burdensome and the state determined that expansion of PE is not necessary to ensure timely enrollment into Kentucky HEALTH.

Putnam laid out a proposed road map of the modifications.

“We have a phase one we’re anticipating an implementation in January 2018 that would include identification of Kentucky HEALTH population for outreach purposes,” Putnam said. “It would also include the opportunity to begin earning My Rewards dollars in January through accessing preventive services.”

After the meeting, over a dozen people voiced their opinions about the Medicaid changes with most in opposition of the modifications.

Those folks waited over 3 hours to address cabinet officials during a public hearing which was scheduled for 10:00-12:00, but, in fact, did not start until after the committee meeting ended close to 1:00.

The public comments period on Medicaid modifications will run through 11:59 p.m. on August 2.

Written feedback can be submitted via email to kyhealth@ky.gov


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