By Melissa Patrick
Kentucky Health News
A poll conducted for a group opposing Gov. Matt Bevin’s coming changes to the Medicaid program shows that two-thirds of Kentucky voters oppose the changes generally, and specifically oppose cutting back coverage of dental and vision care and non-emergency transportation services.
InsureKY, which released the poll, is a statewide coalition of nonprofits “formed to promote more affordable health insurance, better care, and stronger consumer protections for all Kentuckians,” according to the release. The Kentucky Equal Justice Center, a member of the coalition, paid for the two questions in the Mason-Dixon Polling & Research survey, taken Dec. 12-15.
The first question offered respondents a very simple description of the plan and one of its effects: “Federal officials recently approved Governor Matt Bevin’s ‘waiver’ that will change Kentucky’s Medicaid plan and reduce the number of people who receive benefits.” The last statement is based on the state’s estimate that after five years the program will have 95,000 fewer beneficaries than it would have without the changes. (Tens of thousands of Kentuckians go on and off Medicaid each month.)
After the simple descriptions, the poll asked, “Do you feel the Medicaid program in Kentucky should be scaled back or do you feel the Medicaid program in Kentucky should be left as it is?” Sixty-six percent said the program should be left as it is, 25 percent said it should be scaled back, and 9 percent said they weren’t sure.
Most registered voters in each of the state’s five regions said they wanted the program to be left alone, with the highest share in Louisville, 70 percent, and the lowest in Northern Kentucky, 59 percent.
There was a difference among political affiliation, with 77 percent of Democrats, 64 percent of independents and 53 percent of Republicans saying they opposed the changes.
At 33 percent, Republican voters had the highest percentage saying they wanted the program scaled back, followed by independents at 28 percent and 19 percent of Democrats.
The second question asked: “Another change Governor Bevin is making to Medicaid is to remove dental, vision, and non-emergency medical transportation coverage for nearly half a million adults. Instead, these adults would have to earn dental and vision services by completing healthy activities. Do you support or oppose the Governor’s plan to reduce benefits in this way?”
The poll found that 65 percent of registered voters opposed these changes, 28 percent supported them and 7 percent were undecided.
The poll did not ask about the plan’s work requirements, which may be more popular.
The plan also includes premiums, small deductibles or co-payments, strict reporting requirements and lock-outs for non-compliance. It is tentatively set to start April 1, with the work and community engagement options to be phased in regionally.
The plan largely applies to the nearly 500,000 Kentuckians who have gained coverage through expansion of the program to those who earn up to 138 percent of the federal poverty line ($16,753 for an individual). Kentucky has about 1.4 million people on Medicaid, but only 165,000 are expected to come under the work and community engagement requirements.
The new plan was set to roll out July 1, but a federal judge vacated federal approval of it June 29 and sent it back to the Department of Health and Human Services for review, ruling that federal officials had not fully considered the projection of 95,000 fewer people on the Medicaid rolls.
Opponents of the plan have said these new rules and strict reporting requirements will result in fewer Kentuckians having access to health care, often noting the 17,000 people in Arkansas who have lost their Medicaid coverage since June because they did not meet their state’s new work and community engagement requirements.
The Bevin administration has said the new plan isn’t set up to kick people off of the program, but to help them become more engaged in their health care and to help them move to jobs that offer private insurance.
HHS re-approved the plan in November, but more litigation is likely.
Cara Stewart, an attorney with the Kentucky Equal Justice Center, one of the three organizations that filed the original lawsuit on behalf of 16 Kentucky Medicaid recipients, said they will file their amended complaint Monday, Jan. 14, the last day allowed on the judge’s briefing schedule. The state will need to file any opposition to the motion and its reply by Feb. 11.
Less vulnerable to the court challenge is the change that will require people who gained coverage through Medicaid expansion to earn dental and vision care by participating in self-improvement activities, such as passing a GED exam or completing a stop-smoking class. These services have been offered for free.
The new plan also completely removes non-emergency medical transportation services and offers no provision for regaining them.
Opposition to these changes also varied among political parties, with 79 percent of Democrats, 62 percent of independents and 49 percent of Republicans opposing them.
“These results are a strong statement. The policy changes being proposed simply do not align with public sentiment or the realities that low-income Kentuckians face,” Sheila Schuster, executive director of the Advocacy Action Network, said in the release.
The poll surveyed a total of 625 registered Kentucky voters via both land-line and cell-phone numbers. The margin of error in any statewide figure is is plus or minus 4 percentage points, and higher for the regional, partisan and demographic groups.