House Bill 2 puts a price tag on survival for Kentuckians on Medicaid | Opinion

I was 31 years old when I heard the words no one expects to hear in the prime of their life: you have cancer. In 2019, after my cancer diagnosis, I faced a difficult treatment path of surgeries, radiation, immunotherapy, and more.

Now, I’m 38, and last week, I found out I have a recurrence.

What people misunderstand about cancer is that even if the prognosis is favorable, it’s never entirely behind you. I have a lifetime of care with specialist visits, lab work, imaging, procedures, and the constant fear that a new result will change everything again.

Medicaid has been the only reason I have been able to fight cancer and survive. Unfortunately, right now, lawmakers in the KY General Assembly are working on passing House Bill 2, otherwise known as the Medicaid Reform Act. This bill will make access to healthcare harder and more expensive by weakening protections for people like me.

Make no mistake, Kentucky is a Medicaid state. According to the Kentucky Center for Economic Policy, approximately one in three Kentuckians relies on Medicaid health coverage, which translates to about 1.4 million people. That includes children, seniors, people with disabilities, working families, and rural residents like me who already face major barriers to care.

HB 2 does a lot. Supporters argue that it helps with accountability by adding more requirements to the program. The reality is that it builds new hurdles into a program that already asks low-income Kentuckians to prove and re-prove they deserve care.

One of the most startling provisions within HB 2 bill is that eligibility redeterminations will happen every six months. On paper, that sounds like routine oversight. In real life, it can mean coverage interruptions because of missed mail, a changed address, a document the system didn’t receive, or a form submitted but not processed in time.

HB 2 also ties Medicaid eligibility to community engagement requirements and restricts the state’s ability to seek waivers or delays without legislative approval. People who are sick, juggling medical appointments, or managing serious conditions can still get caught in these nets because the burden isn’t just meeting the requirement; rather, it’s documenting it correctly and continuously.

Then there’s the part of the bill that hits me harder than any other provision included in the new legislation.

HB 2 sets up copays for a majority of Medicaid recipients. It establishes copays for non-emergency ER use and inpatient stays and allows a $20 copay for specialized care. That $20 number isn’t theoretical, as Kentuckians are already hearing it discussed as a reasonable amount for specialty care.

Let me translate what that looks like in a real cancer patient’s life.

Because I live in a rural community, my local hospital cannot provide the specialists I need. I often travel to Lexington or Louisville for care. In a single day, I can see up to five specialists for my healthcare needs.

If copays are $20 per provider per visit, that can become $100 in one day, not including funding needed for gas, food, and parking. For someone living on a tight budget, that is an added barrier built out of dollars and miles.

When policymakers design barriers, people don’t stop needing care. They just stop getting it on time. They skip appointments. They delay tests. They ration medications. They hope the symptoms go away. With cancer, any delay can mean the progression of the disease.

That’s the cruelty of this kind of reform because it frames Medicaid recipients as costs to be controlled instead of neighbors who are trying to survive. It treats healthcare like a burden rather than a necessity.

Yes, we should make sure Medicaid dollars are spent responsibly, but reforms that increase paperwork requirements, accelerate redeterminations, and add new costs don’t just target waste and fraud. They hit the people who are already stretched thin, especially those like me in rural Kentucky, where specialist access requires travel and time that many families simply don’t have.

As a Medicaid recipient, I am asking Kentucky lawmakers to look past the label and see the impact. HB 2 doesn’t just reform the program. It changes the terms of survival for Kentuckians like me who rely on it.

We can safeguard the integrity of Medicaid without putting a price tag on survival. Kentucky must reject any so-called reform that turns lifesaving care into a luxury, especially when one in three of our neighbors depend on this program to live.

Cara Ellis is a current political science student at Morehead State University and is known as an Appalachian organizer and advocate. She focuses her work on public policy, rural equity, and civic engagement across eastern Kentucky.