Gov. Matt Bevin

Gov. Matt Bevin issued an executive order Tuesday directing his administration to end Medicaid expansion in Kentucky — which covers roughly 500,000 individuals in the state — if any part of his Section 1115 waiver approved by the federal government last week is blocked by a legal challenge in the court system.

The Bevin administration’s waiver plan was approved by the federal Centers for Medicare and Medicaid Services on Friday, which adds insurance premiums and work requirements for “able-bodied” Medicaid recipients. The Washington-based advocacy group National Health Law Program told the Courier Journal following this announcement that it would anticipate filing a lawsuit to challenge these parts of Bevin’s HEALTH plan as violating federal Medicaid law, as well as the elimination of transportation services to medical appointments.

The executive order issued Tuesday by the governor states that “in the event that one or more of the components” of his HEALTH plan “are prohibited from being implemented pursuant to a final judgment issued by a court of competent jurisdiction, with all appeals of the judgment having been exhausted of waived,” he would direct the leadership with his Cabinet for Health and Family Services “to take the necessary actions to terminate Kentucky’s Medicaid expansion program.”

The order adds that this potential elimination of Medicaid expansion would take place “no later than six months from the date on which all appeals of the judgment have been exhausted or waived, or otherwise as soon as legally practicable under the remaining terms” of the waiver plan, applicable statutes or regulations.

Critics of Bevin’s Medicaid plan immediately characterized the governor’s executive order as an ultimatum threatening to end health insurance coverage for 500,000 Kentuckians under expanded Medicaid unless his plan is left completely intact.

“He’s saying if the courts don’t let me take Medicaid expansion coverage from many people, I will take it from all people,” said Jason Bailey, the director of the progressive Kentucky Center for Economic Policy. “Neither is acceptable for Kentucky’s health and economy.”

Congressman John Yarmuth, who last week called Bevin’s HEALTH plan “an unconscionable attack on our state’s health” that will literally cause Kentuckians to die, ripped Tuesday’s executive order in a statement sent to IL.

“If the Bevin administration has made any errors or drafted this reckless Medicaid waiver in a way that doesn’t meet legal standards, they could redraft and resubmit the request,” said Yarmuth. “Instead, the Governor will punish the more than a half million Kentuckians by entirely eliminating their health care coverage. It’s hard to imagine anything more spiteful and less rational than that.”

In the executive order, Bevin states that his HEALTH plan would be “substantially compromised” if any part of it was blocked by judicial actions, nor would the state “be able to afford to continue its Medicaid expansion program.”

Bevin’s order also stated that “statistical data collected by the Commonwealth confirms that merely providing access to health care alone to Medicaid beneficiaries without simultaneously addressing various social determinants of health and poverty does not meaningfully correlate to better health outcomes for Medicaid beneficiaries.”

No lawsuit has yet been filed to challenge the new HEALTH plan in Kentucky.