Medicaid

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Medicaid advocates, family members and policy experts gathered in Frankfort Monday to weigh in on proposed changes to the state-run insurance program for low-income and disabled people.

Kentucky’s Medicaid program was expanded by former Gov. Steve Beshear under the Affordable Care Act. But current Gov. Matt Bevin has said the costs associated with the program aren’t sustainable, and is asking the federal government to approve a plan to scale it back.

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The first of two public hearings seeking input on Governor Bevin’s Medicaid waiver was held Friday in Somerset.

Governor Bevin wants to overhaul the Medicaid program, in hopes of moving more people to private insurance coverage. Bevin said Kentucky can’t afford to pay for everyone that gained coverage when Medicaid was expanded.

 

The new plan calls for Medicaid recipients to pay premiums of up to $15 a month. Beneficiaries would be required to work or volunteer for 20 hours a week in order to keep their benefits. Those requirements don’t apply to everyone.

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Vice President Mike Pence will be in Lexington Wednesday as part of the White House’s campaign to roll back the Affordable Care Act.

According to a news release, Pence will participate in a listening session with business leaders who say they’ve been hurt by Obamacare and then hold an invite-only event at Bryant’s Rent-All, an equipment rental company.

The event comes as Kentucky has once again become a key battleground in the fight over the health care law.

Medicaid Changes Could Save Money; Others to Lose Benefits

Jul 4, 2017
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Proposed changes to Kentucky's Medicaid program could cost another 9,000 vulnerable people their health coverage while possibly saving taxpayers an extra $27 million.

Those are both projections for Republican Gov. Matt Bevin's updated plan to overhaul the state's Medicaid program, the joint federal and state health coverage program for the poor and the disabled.

Bevin asked the federal government last year for permission to overhaul the program. Monday, Bevin updated that proposal. State officials estimate the changes would increase taxpayer savings to $358 million by 2021. But it means a total of 95,000 people —9,000 more than originally proposed_would likely lose their Medicaid coverage in a mostly poor, rural state where more than a quarter of the population relies on the taxpayer-funded program to pay for their health care.

GOP's Health Care Rollback Collides with the Opioid Epidemic

Jun 20, 2017
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The Republican campaign to roll back former President Barack Obama's health care law is colliding with the opioid epidemic. Medicaid cutbacks would hit hard in states deeply affected by the addiction crisis and struggling to turn the corner, according to state data and concerned lawmakers in both parties.

The central issue is that the House health care bill would phase out expanded Medicaid, which allows states to provide federally backed insurance to low-income adults previously not eligible. Many people in that demographic are in their 20s and 30s and dealing with opioid addiction. Dollars from Washington have allowed states to boost their response to the crisis, paying for medication, counseling, therapy and other services.

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If Republicans in Congress move forward with their plan to replace Obamacare, Kentucky Governor Matt Bevin's ideas for the future of the program could also go up in smoke.

About 440,000 people were added to the state’s Medicaid rolls as a result of former Gov. Steve Beshear’s executive order to expand the program in 2013, making more people eligible for benefits under the Affordable Care Act.


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Kentucky and other Medicaid expansion states are seeing an increase in overall emergency room visits.

Still, fewer uninsured people are going to the ER under the Affordable Care Act.

In 2014, states with expanded Medicaid access saw an 8.8 percent increase in the share of ER visits covered by Medicaid, according to a study published in the Annals of Emergency Medicine. The share of visits by those without insurance decreased by 5.3 percent. Those with private insurance remained the same in expansion states.

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Louisville Congressman John Yarmuth is asking the federal Department of Health and Human Services for an update on Kentucky Gov. Matt Bevin’s Medicaid expansion changes.

Yarmuth wrote the letter Thursday.

Last August, Bevin proposed several changes for Kentuckians on Medicaid — both those that got their insurance through the Medicaid expansion and make up to 138 percent of the poverty level, and traditional Medicaid enrollees, which includes people living in poverty.

Kentucky ranks 34th in the nation in overall child well-being, according to a new report from the Annie E. Casey Foundation.

The 2017 Kids Count Data Book shows the commonwealth ranking even lower in the category of economic well-being at 39th among states. Terry Brooks with Kentucky Youth Advocates says poverty remains the state’s most persistent challenge for children.

"Unless and until we begin to attack poverty in an intentional and long-term manner, we're just nibbling at the edges of every other sector connected to kids," Brooks told WKU Public Radio.

Kentucky Spent $3.7M On Gunshot Victim Care In 2014

Feb 1, 2017
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The average cost of a gunshot victim’s emergency room or hospital stay in Kentucky was $10,000 in 2014. That’s according to a report out from the Urban Institute.

The total costs of these stays was $3.7 million, with the majority coming from inpatient stays.

And most of that care was provided by a government program. In 2014, the majority of gunshot victims in Kentucky hospitals — 68 percent — had their care paid for by public insurance like Medicaid. In 2010, 54 percent of gunshot victims had no insurance at all. Kentucky expanded its Medicaid program to childless adults in 2014 as part of the Affordable Care Act.

As Congress weighs repeal of the Affordable Care Act, the home state of Vice President Mike Pence Tuesday sought to keep its conservative-style Medicaid expansion under the federal health the health law.

Gov. Matt Bevin’s administration is moving forward with a plan that would alter the state’s expanded Medicaid system, even if the Affordable Care Act is repealed or replaced by Congress.

The proposal has been billed as a way to get Medicaid recipients more involved in their healthcare choices and also a way to reduce Medicaid costs for the state. Bevin’s administration expects about 86,000 fewer people would be enrolled in Medicaid if the waiver is approved.

Vickie Yates Brown Glisson, secretary of the Cabinet for Health and Family Services, said on Wednesday that the state would still move forward with the plan, even if Congress moves to fully repeal the Affordable Care Act.

Kentucky’s Medicaid expansion has led to a dramatic increase in substance abuse treatment services. The Foundation for a Healthy Kentucky has examined substance abuse services covered by Medicaid between 2014 and mid-2016.

 

The group’s report found that Medicaid beneficiaries received 740-percent more treatment services for substance abuse issues over that 30-month period. Before the Affordable Care Act in 2012, about 585-thousand Kentuckians lacked health insurance, and therefore had no coverage for drug and alcohol treatment services.

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To get a glimpse of where Medicaid may be headed after Donald Trump moves into the White House, it may be wise to look to Indiana.

That’s where Seema Verma, Trump’s pick to run the Centers for Medicare and Medicaid Services, comes from. And that’s where she put her stamp on the state’s health care program for the poor.

Verma is a private consultant who was hired by Indiana Governor and Vice President-elect Mike Pence to design a Republican-friendly expansion of Medicaid under the Affordable Care Act. The state paid her almost $5 million over four years through 2017, according to the contracts.

Healthcare.gov

More than 30,000 Kentuckians have signed up for health insurance since the state transitioned to the federal exchange on November 1.  Healthcare.gov replaced the state’s previous insurance portal known as Kynect.  This time last year, more than 27,000 Kentuckians had enrolled in coverage, according to state officials. 

Melissa Grimes works for Community Action of Southern Kentucky, which serves 11 counties.  She oversees the assistors who are trained to help enrollees navigate the online process.  Grimes says it’s taking longer to enroll people under the federal exchange.

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