Fayette County

Bevin exempts Medicaid from spending cuts but vows to end Kynect

Kentucky Governor Matt Bevin smiles as he is introduced at the Kentucky Chamber of Commerce dinner, Thursday, Jan. 7, 2016 at Heritage Hall in Lexington, Ky.
Kentucky Governor Matt Bevin smiles as he is introduced at the Kentucky Chamber of Commerce dinner, Thursday, Jan. 7, 2016 at Heritage Hall in Lexington, Ky. Associated Press

Gov. Matt Bevin wants to spare the state’s Medicaid program from any immediate cuts and provide pay increases for social workers.

He also plans to end within a year Kynect, the health-insurance exchange started by former Gov. Steve Beshear, and increase funding for centers that assist abused and neglected children, a project pushed by his wife, Glenna Bevin.

Bevin highlighted those health issues in the $21 billion, two-year budget plan he unveiled to state lawmakers Tuesday. They now will craft their own spending plan for the state and try to reach agreement with the governor on a final budget before this year’s General Assembly ends in mid-April.

Bevin said Tuesday his administration is pursuing a federal waiver that will allow Kentucky “to redesign and revamp the Medicaid program in order to transition it into something more affordable, more sustainable and more tailored to Kentucky’s needs.”

He said his budget proposal contains funding to maintain current Medicaid services during the waiver negotiations with the Centers for Medicare and Medicaid Services. He did not immediately say how much money he wants to set aside for Medicaid.

Beshear, a Democrat, expanded Medicaid in the state under the federal Affordable Care Act, adding about 425,000 Kentuckians to the health care program for the poor. It affected people earning up to 138 percent of the federal poverty level. That amounts to about $16,200 a year for one person.

Bevin said major changes in the program probably would not occur until 2017. The current program covers about 1.3 million Kentuckians. The federal government picks ups 70 percent of costs for about 875,000 Kentuckians who have traditionally qualified for Medicaid and 100 percent of the cost for those added in Beshear’s expansion. The state will begin paying for a small portion of the expanded Medicaid program next year, increasing to 10 percent by 2020.

The Republican governor who took office Dec. 8 was specific in saying that Kynect “is going away” and added that it won’t be in existence a year from now. The exchange offers a website to shop for health coverage.

Bevin predicted that a move to the federal exchange, Healthcare.gov, will save the state millions of dollars each year. He said the change would not take effect until next year, after open enrollment ends for 2017.

State Democratic Party Chair Patrick Hughes said in a statement that he was pleased Bevin “has backed away from his campaign promise to reverse Medicaid expansion” but he hoped the governor would “also reverse his promise to dismantle the widely popular Kynect system, since so many Kentuckians have depended on it to access high-quality and affordable health care.”

Hughes predicted that dismantling Kynect will cost the state about $23 million “and force premiums to rise. Because of Gov. Bevin’s decision, we may be on the hook to repay $57 million to the federal government. That doesn’t sound fiscally conservative or wise to us.”

Bevin said his budget also helps social workers and guardians.

It calls for an additional $4.8 million over the next two years to fund salary increases for new and entry-level social workers and clinicians in the Department for Community Based Services and the state’s Aging and Independent Living Services department. This would affect about 2,030 social workers.

The Department for Community Based Services provides child care, child and adult protection, determines eligibility for Medicaid and food benefits, and administers a program to help the needy with their energy bills. The aging services agency assists Kentucky’s elders and individuals with disabilities.

Bevin’s budget would allocate an additional $964,100 to reduce the caseloads of guardians — state employees who care for people who cannot make their own health and financial decisions because of mental or physical disorders.

His budget proposes an additional $1.6 million over the next two years for 15 children’s advocacy centers in the state. They provide care and resources to abused and neglected children. The centers have not seen any increase in funding since 2008, the governor said.

Jack Brammer: (502) 227-1198, @BGPolitics