Medicaid

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Dentist Garth Bobrowski gives away thousands of dollars in free dental care for patients who can’t afford it in his small town of Greensburg, Kentucky.

“Dentists serve patients in their communities in these rural towns because these folks are our folks. We go to church with them, we go to school with them,” Bobrowski said. “So we do it as a service to the community.”


As the Trump administration moves to give states more flexibility in running Medicaid, advocates for the poor are keeping a close eye on Indiana to see whether such conservative ideas improve or harm care.

Indiana in 2015 implemented some of the most radical changes seen to the state-federal program that covers nearly 1 in 4 low-income Americans — including charging some adults a monthly premium and locking out for six months some of those who don't pay their premiums.

Several advocacy groups are suing the federal government on behalf of 15 Kentuckians who are enrolled in Medicaid, saying that Kentucky’s recently approved Medicaid changes violate the Social Security Act.

The approved Medicaid waiver, as the changes are called, will make many Medicaid enrollees work, volunteer or do other activities for 80 hours a month to keep health coverage. It also will limit access to dental and vision services for some, make other enrollees pay premiums and install lock-out periods for not making those payments.

Which Kentucky Counties Benefited Most Under Medicaid Expansion? Here’s A Map

Jan 19, 2018
Alexandra Kanik

Starting this July, Kentucky will start making some Medicaid enrollees work, volunteer, take classes or train for jobs in order to keep health care coverage. Last week, the federal government approved the long-awaited Medicaid waiver that Governor Matt Bevin submitted in the summer of 2015.

The waiver includes several changes to Medicaid, and the bulk of these changes will affect people who received coverage under the expansion of the program made possible by the Affordable Care Act. Here’s how many people in each of Kentucky’s counties fall into that group:

The insurance program that provides health insurance to almost a third of Kentuckians — Medicaid — will soon change. Kentucky Governor Matt Bevin is awaiting approval from the federal government on his proposed reforms. But even if Bevin gets everything he asked for, Medicaid providers and advocates say there are still a lot of unknowns to how Kentucky will manage the program.

In Kentucky, Medicaid used to just cover pregnant women, children or people who were disabled or living in poverty. Under President Barack Obama’s Affordable Care Act, former Governor Steve Beshear expanded the insurance program to include people living outside of poverty – up to about $33,000 a year for a family of four. The program now covers about a third of Kentuckians, many of whom got on Medicaid through the expansion.

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Despite numerous failed legislative attempts to repeal and replace the Affordable Care Act, the Trump administration is rolling out regulatory changes that are likely to clear the way for Kentucky’s plan to remake its Medicaid system.

At a National Association of Medicaid Directors conference in Arlington, Virginia on Tuesday, Trump administration official Seema Verma said the government will give states more freedom over their Medicaid programs, including allowing states to require Medicaid enrollees to work or volunteer to keep their coverage.

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Kentucky regulators say they’ll go to court to keep from handing over documents related to the state’s plan to reconfigure its Medicaid insurance program. But legal experts say Kentucky’s argument — that it doesn’t have to turn over emails and other communications because they are preliminary and about negotiations — doesn’t hold up.

Since they were first proposed in August 2016, Gov. Matt Bevin’s planned changes to Medicaid have been controversial. Medicaid is the federal program for disabled and low-income people — a program which Kentucky expanded under the Affordable Care Act and previous Gov. Steve Beshear.

J. Tyler Franklin

Amanda Mills has insurance through Kentucky’s expanded Medicaid program. She also has a full-time job working with homeless people in Louisville.

In January, she’ll lose Medicaid coverage because she makes $1,000-a-year more than the threshold, which is about $28,000 per year. And, she says, she won’t be able to afford the insurance her employer offers, plunging her into a familiar gap created by the Affordable Care Act where people earn too much for Medicaid but too little for a subsidy to assist with premiums.

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A former dentistry professor says members of Gov. Matt Bevin’s administration pressured University of Kentucky officials to fire him after he wrote a critique of the governor’s plan to reshape the state’s Medicaid system.

Dr. Raynor Mullins, who worked at UK for more than 40 years, filed the suit in federal court against UK Healthcare Vice President Mark Birdwhistell, UK College of Dentistry Dean Stephanos Kyrkanides and an unknown member of Gov. Matt Bevin’s administration listed as “John Doe.”

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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
Flickr/Creative Commons/Dimitris Kalogeropoylos

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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