Ky. still pursuing Medicaid waiver; Obamacare repeal could convert the program to block grants, giving states more flexibility

Kentucky will continue pursuing its proposed changes for the expanded Medicaid program even if Congress repeals and replaces the law that authorized the expansion, state Health Secretary Vickie Yates Brown Glisson told Ryland Barton of WFPL in Louisville.


“At this point, the governor has said to me ‘That is my number one priority, you’ve got to get this done in 2017 and have it ready to go on January 1st of 2018’,” Glisson said.

“Last year, Bevin formally asked the federal government for permission to require able-bodied Medicaid enrollees to work or volunteer up to 20 hours a week and pay a monthly fee ranging from $1 to $15 to receive benefits,” Barton notes. “The plan also removes vision and dental coverage from the built-in list of benefits. Medicaid recipients would be able to earn credits to purchase vision or dental benefits by participating in volunteer work or taking a health risk assessment.”

President Donald Trump and congressional Republicans have talked about converting Medicaid to a block-grant program, in which states would get a certain amount of funding based on current expenses, rather than just paying 70 percent of whatever the cost is.

Block grants typically give states more freedom to set rules for programs, and “Glisson said the state might be able to implement the waiver, or a policy similar to it,” if the replacement law authorizes block grants, Barton reports.

“If we get approved, I think it answers a lot of questions that I think other states have had, a lot of things that they put in their waivers and maybe were not entirely approved,” Glisson told WFPL. “If this gets approved, yes, I think it’s really going to really set a tone, I think it’ll be a model for the rest of the country.”

Officials of the Obama administration refused to approve work requirements or fees that would be obstacles to coverage, but they never ruled on Bevin’s request. Now approval appears likely because the Centers for Medicare and Medicaid Services will be run by Seema Verna, who shaped the Medicaid waiver in Indiana, on which much of Kentucky’s proposal is modeled.

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