Medicaid expansion

Rhonda J. Miller

About 125 people attended a public hearing in Bowling Green on June 28 to get an overview and offer comments on Gov. Matt Bevin’s proposed changes to Kentucky’s Medicaid program.

Vickie Yates Glisson is secretary of the Kentucky Cabinet for Health and Family Services. At the public hearing, she said one of the major proposed changes is that instead of copays for medical services, those on Medicaid will pay a small monthly premium. Glisson said the proposal also seeks to include services that address Kentucky’s most critical health issues. 

Cardiovascular health, we have the fourth highest in the nation in heart disease. We have the highest rate of cancers, so we’re addressing lung cancer, smoking cessation, slash lung cancer. We have an out of control drug abuse problem.”

Some at the hearing expressed concern that even a small monthly premium would be barrier to health care for low-income residents. 

Another area of concern that some expressed is that dental and vision care are not included in the basic health care plan.

Lisa Autry

This is the second of a two-part series on proposed changes to Kentucky Medicaid and how Governor Matt Bevin wants to model the program after a similar one in Indiana.  You can see Part 1 here.

When the federal Affordable Care Act was rolled out, Indiana was faced with the same dilemma as other states: give health coverage to more of the uninsured by expanding Medicaid, while taking on hundreds of millions of dollars in costs. 

Indiana Governor Mike Pence persuaded the federal government to approve an alternative for his state. Just over a year ago, the state implemented the Healthy Indiana Plan 2.0.  Kentucky Governor Matt Bevin wants to launch a similar program as he looks to revamp his state's Medicaid system. 

In the year since Indiana implemented the Healthy Indiana Plan 2.0, or HIP, more than 370,000 Hoosiers have enrolled in the program.  Among them is Mary Buchanan, who is self-employed.  A shoulder injury no longer allows her to work full-time.  By working less, the 63-year-old from Rockport couldn’t afford the private insurance she used to carry.  She picked up the Healthy Indiana Plan 2.0, or HIP, about a year ago.

"One less thing for me to worry about 24\7, said Buchanon, who met WKU Public Radio at the Spencer County Library.  "What if something happens to me?  Am I going to have to file bankruptcy?  One trip to the hospital can wipe you out.”

Under HIP 2.0, Buchanan pays just under $14 a month in premiums and has no co-pays or deductibles for her medical care.

Kentucky Governor Steve Beshear is set to announce whether or not he’ll expand Kentucky’s Medicaid program.

The Governor’s office says Beshear will share his decision Thursday at a 1:30 p.m. eastern time news conference at the state capitol building.

Under the federal Affordable Care Act, each state has the option of expanding its Medicaid services to those earning less than 133 percent of the poverty rate. The federal government has agreed to pay each state’s additional costs related to expansion for the first three years, with Washington picking up 90 percent of the tab each following year.

Some conservatives and Tea Party activists have called on Beshear not to agree to the expansion, saying the commonwealth can’t afford any additional costs.

Supporters say it’s a once-in-a-lifetime opportunity to extend the program to a wider number of Kentuckians who are struggling with high health care costs.

The chairman of a Kentucky Senate committee is promising to file legislation aimed at preventing Gov. Beshear from setting up two major pieces of the federal health care law without legislative approval.

The Courier-Journal reports Senate Health and Welfare Committee Chair and Louisville Republican Julie Denton says she doesn’t want the Governor to be able to unilaterally establish a new statewide health care exchange or expand Medicaid services to more Kentuckians. Denton and other Obamacare opponents say the state can’t afford the exchange or expanded Medicaid offerings.

Denton’s bill would make such moves contingent on General Assembly approval. Gov. Beshear has already taken steps to create a statewide health care exchange by 2014, which would allow those who don’t get insurance at work to buy a plan from a private company and receive government subsidies in the process.

The Medicaid expansion would allow those earning less than 133 percent of the poverty rate to qualify for the program. Beshear says he is still considering the Medicaid expansion, while House Speaker Greg Stumbo says he fully supports the move.