Health advocacy group says revised Medicaid program should improve health and manage cost, without creating barriers

By Melissa Patrick
Kentucky Health News

A health-care advocacy group says the redesign of the Medicaid program should build on the expansion of eligibility and not include any more costs for patients.

“Kentucky has made tremendous gains in improving the health of its people since the expansion of Medicaid. More Kentuckians are receiving preventive services, substance use treatment and other critically needed care than ever before,” Emily Beauregard, executive director of Kentucky Voices for Health, said in a news release. “Any changes to the program should build on this success.”

Under federal health reform, then-Gov. Steve Beshear expanded Medicaid to households with incomes up to 138 percent of the federal poverty level, which added about 400,000 more Kentuckians to the rolls. The federal government pays for the expansion through this year, but next year the state will be responsible for 5 percent, rising in annual steps to the reform law’s limit of 10 percent in 2020. In all, about 1.3 million Kentuckians get free health care through Medicaid.

Gov. Matt Bevin has said the state can’t afford to have more than a fourth of its population on Medicaid and has charged his administration to come up with a revised program that will improve health outcomes while making the expansion financially sustainable. Bevin hopes to accomplish this through a waiver from the federal government.

Bevin has said he favors a waiver program like Indiana’s, which includes premiums and co-pays in some tiers of coverage, but has also said that he is not limited by this model and will develop a waiver to best fit the needs of Kentucky.

Kentucky Voices for Health is a coalition  of organizations that favor federal health reform, some of of which lobby the government. It said changes should engage consumers in their care and develop new ways to deliver care, without any obstacles to coverage such as premiums.

“Coverage is foundational,” Rich Seckel, executive director of Kentucky Equal Justice Center, said in the release. “It empowers us with tools to achieve and maintain health.”

The coalition also said the program should focus on coordination of care in areas with high use, and build on Kentucky’s Health Data Trust, which provides complete and transparent information about healthcare utilization and outcomes to improve public health and quality of care delivery. Click here for the full report.

The group stressed the importance of meaningful stakeholder input to ensure the waiver is designed to meet the unique needs of Kentucky. So far, the administration has had no formal stakeholder meetings on the issue.

Under federal law, states seeking a waiver must hold at least two public hearings; one before it is submitted to the Centers for Medicare and Medicaid Services and the second after CMS accepts the application.

Amanda Stamper, press secretary to Bevin, told The Courier-Journal that the administration welcomed “this sort of thoughtful input,” and when asked if the waiver would include any premiums or co-pays said, “Everything is on the table and no decisions have been finalized.”

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