Politics & Government

Ky. shouldn’t go ‘backward’ on Medicaid expansion, federal official says

Gov. Matt Bevin, right, unveiled details of his plan to overhaul Medicaid at a news conference in the state Capitol rotunda on June 22. On the left is Mark D. Birdwhistell, who assembled a team of experts to assist in the drafting of a Medicaid waiver application.
Gov. Matt Bevin, right, unveiled details of his plan to overhaul Medicaid at a news conference in the state Capitol rotunda on June 22. On the left is Mark D. Birdwhistell, who assembled a team of experts to assist in the drafting of a Medicaid waiver application. Charles Bertram

The U.S. Department of Health and Human Services is unlikely to approve changes to Kentucky’s Medicaid program that would interfere with its “extremely successful” progress at helping more people get health insurance, a top official said Wednesday.

HHS is currently considering a Medicaid waiver proposal, submitted last month by Gov. Matt Bevin, that would reshape the program that provides health insurance for 1.32 million Kentuckians. Over the next five years, it could shave $2.2 billion off the expected $37.2 billion expense of Kentucky’s Medicaid program, according to the waiver application.

However, as it weighs Bevin’s proposal, HHS will keep its eyes on the sharp drop in the size of Kentucky’s uninsured population since former Gov. Steve Beshear expanded Medicaid coverage to working-poor adults in 2013, Aviva Aron-Dine, senior counselor to HHS Secretary Sylvia Mathews Burwell, told the Herald-Leader. The Census Bureau unveiled data Tuesday showing that only 6 percent of Kentuckians lacked health insurance in 2015, a drop of 8.3 percentage points over the last two years.

“Kentucky’s Medicaid expansion has been extremely successful across a range of dimensions. It’s contributed to one of the largest reductions in uninsured in America. It’s contributed to improvements in health care access,” Aron-Dine said.

“So when we look at any potential changes to Kentucky’s, or any other state’s Medicaid programs, what we’re looking for is changes that build on that success and don’t take Kentucky or any other state backward,” she said. “As in other states, we’re happy and prepared to continue our dialogue with the state for as long as it takes to find a solution that meets that critical criterion of moving the state forward and building on its progress.”

Bevin’s waiver proposal would — if approved — allow the state to set new costs and restrictions for Medicaid recipients, such as charging co-pays and premiums and eliminating dental and vision care as part of standard coverage. Able-bodied adults would have to be engaged in their communities for at least 20 hours every week, through a job, classes, volunteering or other specified activities.

Bevin told reporters last month that he’s not inclined to negotiate on the key points in his proposal.

“It has been clear even when I was a candidate, certainly since I’ve been governor, from the moment of my inaugural speech to my budget address and every time I’ve been on record since then,” Bevin said at the time. “If, in fact, there are not structural changes made, there will not be the ability to have an expanded Medicaid in Kentucky. That’s just the reality of it. So the ball is in their court. If there is to be expanded Medicaid in Kentucky, it is entirely up to them.”

John Cheves: 859-231-3266, @BGPolitics

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