Ky. gov threatens end to Medicaid expansion without work requirements
© Greg Nash

Kentucky Gov. Matt Bevin is threatening to end the Affordable Care Act's Medicaid expansion in his state if a court blocks a recently approved waiver requiring Medicaid recipients to work.

Bevin, a Republican, signed an executive order last week directing the Health and Family Services Cabinet to end the Medicaid expansion in Kentucky if a court strikes down the state's so-called Medicaid 1115 waiver, which won federal approval last week.

Bevin's order was first reported on Wednesday by the Lexington Herald-Leader.


Several advocacy groups have threatened to sue the first state that implements the 1115 waiver if it results in people being involuntarily cut from Medicaid or reduces coverage.

"[T]he Commonwealth has invested significant resources in preparing for the implementation of Kentucky's 1115 Waiver, and any delay in the implementation of the waiver due to judicial action will cause fiscal harm to the commonwealth and will prevent Medicaid beneficiaries from realizing the benefits under the Waiver,” Bevin's executive order reads.

Under Kentucky's 1115 waiver, able-bodied adults between the ages of 18 and 64 would be required to complete 80 hours of "community engagement" each month as a condition for receiving Medicaid coverage. 

It also requires recipients to pay $15 per month for their health care, and does away with basic dental and vision insurance, unless people participate in a sort of health rewards program, according to the Herald-Leader.

The changes to the program, which go into effect July 1, came after the Trump administration issued new guidance last week allowing states to compel Medicaid recipients to participate in "community engagement." That includes work, school, volunteer efforts or other approved activities.