The Foundation for a Healthy Kentucky announced at a news conference Wednesday that it was partnering with Gov. Matt Bevin’s administration to help implement the state’s new Medicaid waiver program, in an effort to make sure that no one is dropped from coverage under its new work requirements.
The Section 1115 waiver approved by the Trump administration in January would allow the state to require premium payments and a minimum number of hours worked to maintain Medicaid coverage, though officials with the Cabinet for Health and Family Services prefer to call this a “community engagement” requirement, as it includes volunteering, job training and taking classes.
Though a federal lawsuit has been filed to stop the waiver before it can go into effect, Bevin’s new Kentucky HEALTH program is set to begin its rollout with Campbell County in July, and then launch in Jefferson County in October.
Ben Chandler, the president and CEO of the nonprofit Foundation for a Healthy Kentucky, explained that his organization was teaming up with the Bevin administration because its goal is to improve people’s health, and the foundation could advance that mission if it helped Medicaid beneficiaries meet the new requirements and maintain coverage.
“We have a singular objective in the endeavor announced today, and that is to keep Kentuckians covered,” Chandler said.
Noting that taking advantage of preventive care services is not possible without coverage, Chandler said his organization would assist people in paying premiums, meeting work or community engagement requirements and advancing health and financial literacy.
He also said the foundation would “facilitate a statewide feedback program” on the waiver implementation “to identify best practices and lessons learned, and to resolve program inefficiencies.”
Noting that many stakeholders have concerns about the new requirements under the Medicaid waiver and the possibility of many thousands losing coverage, Chandler said the foundation shared those concerns, “and we’re committed to keeping as many people covered as possible.”
He said that Veronica Judy Cecil — a deputy commissioner in the Kentucky Department for Medicaid Services in both the Bevin and Beshear administrations — had been hired to oversee this partnership, helping both Medicaid beneficiaries maintain coverage and employers understand how they can keep those individuals from being locked out of coverage.
Asked if the foundation’s mission to keep people on Medicaid conflicted with the administration’s efforts to reduce the number enrolled in that program, Bevin said his goal has never been to cover fewer people.
“I never said that,” said Bevin. “My goal is to get a healthier outcome for the people of Kentucky. I’ve never made any mention with respect to the size and scope of Medicaid. What I do believe is if you have a healthier population, you won’t need as many people.”
Chandler chimed in to say that “not at any time have any of these folks suggested to us that they are trying to throw people off Medicaid.”
“I don’t think anybody wants people to lose their health coverage,” Chandler said. “I just don’t think that anybody’s got that goal. I hope not. I can assure you that we at the foundation don’t. And as I understand it, neither does the administration.”
Bevin has stated many times that the expansion of Medicaid eligibility in Kentucky under the Affordable Care Act — through which nearly 500,000 gained coverage — is financially unsustainable for the state as its share of such payments increases to 10 percent. The governor has also vowed to end this expansion if his Medicaid waiver plan is blocked by the courts, arguing that the state would no longer be able to afford it.
The Bevin administration has estimated that its Medicaid waiver plan will lead to a decrease in enrollment on nearly 100,000 within the first five years of its implementation, though public health scholars in the lawsuit challenging the waiver estimate that as many as 300,000 could lose coverage within the first year alone.
The lawsuit filed by 15 Medicaid recipients in Kentucky asserts that the federal approval of Kentucky’s waiver violates the Social Security Act and Medicaid Act and endangers the health care of tens of thousands of low-income families in the state.
Asked if the new community engagement requirements will add more red tape for Medicaid recipients, Bevin countered that “it will be easier,” as “we’re trying to simplify this process, not complicate it.”
Chandler said that the Foundation for a Health Kentucky would assist with small-group forums on the Kentucky HEALTH requirements, though the organization is not under contract with the state and would receive no state funding for its efforts.
The foundation will also create an advisory council “to gather and share input among all stakeholders and resolve issues as the waiver is implemented.”
In April, the Bevin administration rejected the proposal of a coalition led by Kentucky Voices for Health to create a stakeholders advisory council to help implement of the new Medicaid changes.
Kristi Putnam, the program manager Kentucky HEALTH, indicated that while the program would begin a wider expansion to counties in the fall, eight eastern Kentucky counties would be exempt from the work requirements throughout next year, as they are part of an existing federal pilot program relating to SNAP benefits.
Asked if the administration considered a similar exemption from work requirements for west Louisville — which suffers from high employment, despite low countywide numbers — Putnam said “there is ongoing analysis and conversation happening about that as we speak.”
In a news release touting the new partnership with the foundation, Cabinet for Health and Family Services Secretary Adam Meier stated that “having support from diverse groups across the Commonwealth is integral to making sure citizens are informed, engaged in the program and moving down the path towards success.”
Derrick Ramsey, the newly appointed secretary of the Education and Workforce Development Cabinet, stated in the same release that Kentucky HEALTH is part of rethinking how support services are delivered.
“We must help individuals become more engaged in their health care, and help employers be more informed and invested in helping individuals transition successfully from benefits programs to commercial insurance,” Ramsey stated.