Gov. Matt Bevin today announced that the federal Centers for Medicare and Medicaid Services (CMS) has approved the Commonwealth's Section 1115 Medicaid waiver known as Kentucky HEALTH. Or, as he said on Friday, the waiver will give enrollees "the dignity associated with being able to earn the things they are receiving".
Ten states - Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, Mississippi, New Hampshire, Utah and Wisconsin - have already requested a waiver from CMS so they can add work requirements to Medicaid. South Dakota's governor said in his State of the State address Tuesday that he would also look to require certain recipients to work. But the long-anticipated CMS announcement - made clear in a letter to states released early Thursday - is a bad sign for some health care advocates, who worry that people will lose coverage because of the additional administrative burden of the requirement.
"Kentucky HEALTH is specifically tailored with the unique needs of Kentuckians in mind". Insofar as expanded Medicaid has become a lot like food stamps-a broad-based entitlement for childless, abled-bodied adults-including work requirements will help enrollees get what they really need: full-time employment.
Under the waiver, about half those in Kentucky who are covered under the Medicaid expansion authorized by the Affordable Care Act will be required to work 20 hours a week or volunteer in their communities for that many hours each week or receive the equivalent number of hours of education.
There are many exemptions to the work requirement, including the "medically frail", a broad term that includes people suffering from chronic alcohol and drug abuse in a state that has been one of the hardest hit by the opioid epidemic. Anyway, it's one of those "damn straight" type ideas that politicians often say they believe, but never actually do because it's not that simple, or because there's too much resistance, or. well, or because they never really meant to do it in the first place. "It will actually help this population reap the rewards of a good job, and one day receive health care coverage from their employer, not the state or federal government", Bryant said.
"There is a real risk of eligible people losing coverage due to their inability to navigate this process or miscommunication or other breakdown in the administrative process", she said in an email to HuffPost.
Greg Moore, state director with Americans for Prosperity, points out that the state budget requires the state to enact work requirements for the Medicaid expansion population by April 30, or notify expansion recipients that the program will terminate on December 31. They wouldn't regain it until they've paid all of their missed premiums.
The state also eliminates its non-emergency transportation benefit for some adults in the program.
Kentucky has been the site of ongoing battles over health care. Pregnant women and children will be exempt from that cost sharing.
In its May 2017 budget proposal, the Trump administration stated its intention to allow states to manage how they administer Medicaid programs. Lawsuits are expected as individual states roll out work requirements. Unfortunately, too many Kentuckians still face barriers to care - especially those with low incomes, people of color, and those living in areas with few health care providers. It is the nation's largest health insurance program. But the expansion under President Barack Obama led to millions of non-disabled low income adults added to the program.