Politics & Government

Proposed Medicaid changes ‘like putting lipstick on a pig,’ state officials told

Pastor: Medicaid revision 'reprehensible, immoral'

Seventeen people testified at the Capitol Annex Monday during the state’s second and final public hearing on Kentucky’s revised federal Medicaid waiver application. The first hearing was held Friday in Somerset.
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Seventeen people testified at the Capitol Annex Monday during the state’s second and final public hearing on Kentucky’s revised federal Medicaid waiver application. The first hearing was held Friday in Somerset.

The Bevin administration’s recent request to the federal government to make changes that would further restrict access to Kentucky’s Medicaid program is “like putting lipstick on a pig,” Harriette Seiler of Frankfort told state officials Monday.

Kent Gilbert, president of the executive board of the Kentucky Council of Churches, called the changes “reprehensible and immoral.”

Clare White of Georgetown said she fears losing her Medicaid under the changes because she is unemployed.

In all, 17 people testified at the Capitol Annex Monday during the state’s second and final public hearing on Kentucky’s revised federal Medicaid waiver application. The first hearing was held Friday in Somerset.

Most of the witnesses had problems with the changes. A few, such as car salesman Johnny Pittman of Louisville, liked them.

Gov. Matt Bevin last year asked the federal government to let Kentucky change its Medicaid program that serves 1.4 million needy and disable people. He said the Medicaid expansion former Gov. Steve Beshear implemented was too costly. It added more than 400,000 Kentuckians to the program.

State Health and Family Services Secretary Vickie Yates Brown Glisson said the latest changes to the state’s waiver application primarily apply to “able-bodied adults” in the Medicaid population in the Beshear expansion and contended they were not designed to “kick off” anyone from Medicaid.

However, state officials estimated the revised plan would save the state an extra $27 million, bringing total estimated savings to $358 million, and cost an additional 9,000 people their health coverage, bringing the total to 95,000 by 2021.

The most controversial measures in Bevin’s original plan include premiums and co-pays and a requirement that able-bodied adults be engaged in their communities for up to 20 hours every week, through a job, classes, volunteering or other specified activities. Also, the plan classifies dental and vision care and over-the-counter medicines as “enhanced benefits” that Medicaid recipients could earn only by performing various tasks. Medical transportation no longer would be covered except for emergencies.

Adam Meir, Bevin’s chief of staff for policy, said the most recent changes would:

▪ Require most able-bodied adults on Medicaid to work or volunteer at least 20 hours a week. The initial waiver application started the requirement at five hours a week and built up to 20.

▪ Lock out benefits for six months for people who do not report changes in salary that might affects their Medicaid income or eligibility.

▪ Cancel a plan to expand Medicaid enrollment centers.

State officials first explained the changes to state legislators on the interim joint Health and Welfare Committee. Two Democratic House members from Louisville — Mary Lou Marzian and Joni Jenkins — complained that the public hearing on the waiver changes were scheduled to run from 10 a.m. to noon but the legislative committee did not finish its work until about 1 p.m. and many who had come to testify had to wait three hours for the hearing.

Once the hearing started, the state officials got an earful of criticism and some praise.

Amy Luttrell, chief executive officer of Goodwill in Kentucky, said her organization endorses the waiver.

But Mark McKinley of Louisville said the waiver and its changes will “take health care coverage from people.”

Seiler said the best health care system would be universal coverage like Medicare.

Rachel Small-Stoke, a pastor at Berea’s United Church, said she appreciates the state’s efforts to try to get people back to work but she said providing health care will motivate people to get a job.

“If they are just scrambling to meet basic requirements just to get their teeth checked, it’s just going to keep people in poverty. I actually wonder if the underlying goal of this is for people not to get health care,” she said. “If that’s the case, that is absolutely immoral.”

Rose Mudd Perkins, a freelance photographer from Georgetown, said Bevin is trying to determine who is worthy of health care. She said Bevin and many others worry about the unborn but are neglecting “those who have left the womb.”

Glisson said the comments at the hearing will be reviewed to see if the state needs to make any modifications to its changes.

The state will continue to take public comments on the changes until 11:59 p.m. Aug. 2. Comments can either be emailed to kyhealth@ky.gov or mailed to Commissioner Stephen Miller, Department of Medicaid Services, 275 East Main Street, Frankfort, Ky., 40621.

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

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