Kentucky submits controversial plan to overhaul Medicaid

Kentucky submits controversial plan to overhaul Medicaid
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Kentucky’s Republican governor, Matt Bevin, on Wednesday submitted his plan for overhauling the state’s Medicaid program under ObamaCare, setting up a potential showdown with the Obama administration. 


Bevin, a fierce opponent of the healthcare overhaul, was elected last year and has promised to change the state’s expansion of Medicaid that came as part of the federal health law. 

On Wednesday the state formally submitted its plan for Medicaid changes, which must now be approved by the federal Department of Health and Human Services (HHS). 

However, several of the changes Kentucky is proposing, which would add conservative features to Medicaid, the government-provided health insurance program for the poor, could run into resistance from the Obama administration. 

For example, Kentucky’s plan includes a controversial requirement that Medicaid enrollees work or volunteer up to 20 hours per week. 

However, the Obama administration has refused to allow work requirements for Medicaid enrollees in previous negotiations with Republican-led states, such as Arkansas. 

“States may not limit access to coverage or benefits by conditioning Medicaid eligibility on work or other activities,” HHS said Wednesday in response to Kentucky’s application. “This requirement is not new.”

Bevin is also seeking to require enrollees to pay premiums. The Obama administration has approved premium requirements in negotiations with other Republican-led states, but the administration cautions that the premiums cannot be too high. 

HHS is cautioning that negotiations could be drawn out.

“As in other states, we are prepared to continue dialogue for as long as it takes to find a solution that maintains and builds on Kentucky's historic progress, and avoids moving backwards,” HHS spokeswoman Marjorie Connolly said in a statement. 

Kentucky’s expansion of Medicaid under ObamaCare increases the eligibility up to 138 percent of the poverty line, which is about $33,000 for a family of four. 

Kentucky has been hailed as a success story for Medicaid expansion. Its uninsured rate has fallen from 18.8 percent in 2013 to 6.8 percent in 2015. 

However, Bevin warns that the program is not fiscally sustainable.

Bevin’s office said the plan will “ensure long-term sustainability of the Medicaid program and familiarize members with commercial insurance and prepare them for self-sufficiency.”