More Kentuckians have health care coverage, but major hurdles loom to keep them covered

09/20/2017 06:43 PM

As the number of Kentuckians with access to health care continues to increase, moves in Congress and within the administration of Gov. Matt Bevin have advocates concerned.

Data released recently shows 97 percent of Kentucky kids, and 95 percent of all Kentuckians now have health insurance.

Dr. Terry Brooks, the executive director of Kentucky Youth Advocates, said the numbers are really powerful as health insurance rates continue to be on the rise.

“We all have to hit the pause button occasionally and celebrate and when it comes to the state of kids, and Kentuckians in general, we can celebrate that more and more folks are being covered by health insurance,” he said.

Kentucky Youth Advocates is watching movement at the federal level on the Children’s Health Insurance Program, known as CHIP, or KCHIP in Kentucky; which provides health coverage for nearly 100,000 Kentucky kids. The current plan expires on September 30, but there is movement on the legislation in Congress.

Last week, the New York Times reported a bipartisan deal to extend CHIP. The agreement would provide federal funds for five-years for the insurance program administered by states. Traditionally the federal government and states share costs of the program, with the federal government carrying the lion’s share in Kentucky.

The Affordable Care Act increased the federal share in each state by 23 percentage points, according to the New York Times. In Kentucky the result is that the federal government pays nearly the entire cost.

However, under the newly proposed legislation states could have to pay a larger percentage. According to the New York Times, “the federal share would continue to be enhanced by 23 percentage points, as under current law, for two more years, in 2018 and 2019. The increase would then be halved, to 11.5 percentage points, in 2020, and would be eliminated in 2021 and 2022.”

“That’s a real issue for the state of Kentucky,” Brooks said.

“The potential for needing a bigger chunk for an already tight budget is something we all need to be thinking and considered about.”

Kentucky Youth Advocates are also watching Congressional action aimed at repealing and replacing parts of the Affordable Care Act.

Transitioning Medicaid

There are new challenges to face at home as well.

Work continues under Gov. Matt Bevin to restructure Medicaid services in the state. Bevin’s administration has submitted an 1115 demonstration waiver to the federal government to significantly alter Medicaid expansion in Kentucky.

Bevin’s proposal, called Kentucky Health, is aimed at familiarizing recipients with private insurance markets so they can transition out of Medicaid and create a sustainable Medicaid delivery model. The plan focuses on personal responsibility in order for low income earners to receive benefits.

The waiver would enact premiums for all but children, disabled adults and pregnant women receiving Medicaid, ranging from $1 per month for those under 25 percent of the federal poverty level to $15 per month for those between 101 percent and 138 percent of the federal poverty level, according to the proposal.

Those in the 101 percent to 138 percent range will pay higher premiums under the plan the longer they’re on Medicaid, maxing out at $37.50 per month after five years in the program.

The program would also kick-out members of the health insurance plan for six-months if they fail to complete certain paperwork, and changes to income and employment in a timely manner.

Changes to the plan are expected to cause many to lose coverage that currently receive health insurance. However, the numbers are up for debate with some saying 95,000 people could lose coverage.

The waiver is currently being reviewed by the Centers for Medicare and Medicaid Services (CMS).

Brooks said there is a real connection between parental health insurance coverage and kid’s coverage. KYA did original research, Brooks said investigating 12 correlates including: zip code, family status, economics and they determined the highest factor for coverage was parental coverage.

“People, frankly have pushed back. They’re like, ‘that’s not a connection,’ well that’s not a formal connection,” he said, adding that evidence is “powerful.”

The full interview, including the rest of Brooks’ concerns over the proposed Medicaid transition is available to view in the clip below.


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