Medicaid

For decades, if people on Medicaid wanted to get treatment for drug or alcohol addiction, they almost always had to rely solely on money from state and local sources.

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States initiatives to expand health insurance coverage through either traditional Medicaid or private insurance have equally good outcomes for low-income adults, according to a study released Tuesday.

The Harvard’s School of Public Health study compared survey results from 5,600 low-income adults in Kentucky, Arkansas and Texas.

The study was released as Kentucky’s new governor mulls reforming the Medicaid expansion. Kentucky expanded its Medicaid program under the Affordable Care Act while Democratic Gov. Steve Beshear was in office. Arkansas, however, used federal dollars to pay for private health insurance for low-income adults.

Texas has not expanded health care at all.

Kentucky and Arkansas saw improvements in health care coverage rates and the ability of low-income adults to obtain prescription medication, chronic disease management, among other things, Sommers said.

According to the study, “the uninsured rate in Kentucky and Arkansas dropped 14 percentage points more than it did in Texas between 2013, prior to full implementation of the ACA’s health insurance provisions, and 2014, after the expansion’s first full year.”

Alix Mattingly

More than two-thirds of Kentucky residents don’t want the state to roll back its expanded Medicaid system, according to a poll released Friday.

The Kaiser Family Foundation poll also shows that half of Kentucky residents hold unfavorable views of the Affordable Care Act, the federal law that allowed the state to expand Medicaid.

“Most of them would rather keep Medicaid as it is today than scale it back to cover fewer people,” said Liz Hamel, director of public opinion and survey research at Kaiser.

The poll found 72 percent of Kentuckians don’t want to scale back Medicaid expansion to cover fewer people.

entucky’s Medicaid expansion — and its fate — are a closely watch component of Gov. Matt Bevin’s administration. Bevin, a Republican who took office Tuesday, campaigned reforming the state’s adoption of the Affordable Care Act.

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The Republican leadership of Kentucky’s state Senate says they will not block about $250 million in state spending needed to pay for the health insurance of more than 400,000 people on the state’s expanded Medicaid program.

The GOP leaders are meeting this week to prioritize bills for the 2016 legislative session, which begins in January.

Outgoing Democratic Gov. Steve Beshear used an executive order to expand Kentucky’s Medicaid program under the federal Affordable Care Act. Incoming Republican Gov.-elect Matt Bevin has promised to repeal the expansion and replace it with something else.

Kentucky will start paying a portion of the Medicaid expansion in 2017. Next month, state lawmakers will debate a two-year state spending plan that would include that money, giving Republicans an opportunity to block it. Republican Senate President Robert Stivers said the Senate does not plan to do that, instead opting for a gradual transition away from the program.

An increase in Medicaid services and a decline in the private insurance market in rural Kentucky has hit rural hospitals hard, according to State Auditor Adam Edelen.

More than two-thirds of Kentucky’s rural hospitals are below the national average on a financial strength rating system, and more than one-third are considered to be in poor financial health, according to a report released Monday.

Governor Bill Haslam is unsure of his next steps after fellow Republicans swiftly defeated his Insure Tennessee proposal in the Legislature this week.

Speaking to reporters after the measure was defeated in the Senate Health Committee on Wednesday, the governor said: "I don't know what the next step looks like."

Haslam was seeking authorization from lawmakers to proceed with an agreement with the federal government to extend coverage to 280,000 low-income Tennesseans.

While the governor had the strong support of hospital and doctors associations and the state Chamber of Commerce, many Republicans remained unwilling to cast their votes in favor of a program funded through President Barack Obama's health care law.

Under the two-year pilot program, Tennessee stood to gain $2.8 billion in federal Medicaid money.

Haslam Convenes Special Session on ACA

Feb 3, 2015

Republican Gov. Bill Haslam says his proposal to extend health coverage to 280,000 low-income Tennesseans is needed to improve lives.

Haslam told lawmakers Monday night it's also needed to fix what Haslam calls a "broken health care system."

Haslam's plan calls on state hospitals to pay the $74 million state share to draw down $2.8 billion dollars in federal Medicaid money to offer coverage to more uninsured Tennesseans.

Indiana has gained approval from the federal government to use an updated version of the state’s Health Indiana Plan, or HIP, instead of Medicaid.

The updated version will be called HIP 2.0, and it will provide health care to 350,000 uninsured Indiana residents.

Indiana Gov. Mike Pence and the Centers for Medicare and Medicaid Services announced the expansion Tuesday.

Gov. Haslam Reaches Medicaid Deal in Tennessee

Dec 15, 2014

Gov. Bill Haslam announced Monday that he has reached a deal with federal officials to expand Medicaid in Tennessee after months of discussions.

The Republican's administration is touting it as an alternative deal with federal officials. The program, dubbed Insure Tennessee, would provide coverage for the state's uninsured without creating new taxes for Tennesseans.

Haslam announced at a news conference at the state Capitol that the state would offer a voucher to purchase insurance in the private market, according to statement from the governor's office and a news conference.

Health care advocates had heavily criticized the Republican governor for refusing last year to agree to $1.4 billion in federal funds to cover about 180,000 uninsured Tennesseans under the terms the money was offered.

Some students headed to college this fall will get top-drawer health coverage at little or no cost.

How? Medicaid, it turns out, will pay the premium for the student health plan.

Proponents say students who are eligible for Medicaid, the health insurance program for low-income people, get access to a wider network of doctors and hospitals by getting coverage through the college health plans. These broad networks can be an important consideration for students who travel for internships, international study or who return to homes far from school during the summer.

Beshear to Hold News Briefing Tuesday on Health Reforms

Sep 10, 2013

Gov. Steve Beshear has scheduled a news briefing Tuesday afternoon to provide an update on efforts to implement federal health care reforms in Kentucky.

The event is set for 1 p.m. EDT at the Capitol.

Beshear has been an advocate for the reforms that he says will provide access to medical care to more than 600,000 uninsured Kentucky residents. Nearly half of those will be added to the state's Medicaid program. The remainder, he said, will be able to get insurance through an online health benefits exchange.

Joining Beshear for the briefing will be Health and Family Services Secretary Audrey Tayse Haynes, Kentucky Health Benefit Exchange Executive Director Carrie Banahan and Kentucky Department of Insurance Commissioner Sharon Clark.

Kentucky is one of six states along with Puerto Rico that will participate in a program to help drive down medical costs by targeting frequent healthcare system users.

Staff from the National Governors Association and other experts will help train officials from participating states to develop a plan for super-utilizers. These are patients who may benefit from less costly, more appropriate treatment elsewhere.

Dr. Stephanie Mayfield is commissioner of Kentucky’s Department of Public Health. She says the commonwealth will focus on frequent emergency room users. Last year, thousands of Medicaid patients used the ER 10 times or more.

“What we’re hoping the plan will be is that emergency rooms are there strictly to be used as emergency rooms and that we develop a plan so that they’re not de facto primary care centers any longer," says Mayfield.

The training academy will help participating states develop plans around healthcare policy. The program will run for a year and begins in August.

Despite an ongoing lawsuit challenging its existence, the Kentucky Health Insurance exchange will start a new advertising campaign next month.

The exchange will work like an online marketplace, and consumers will be able to choose between plans offered by several different insurers, as well as government programs like Medicaid and Medicare.

To get the word out to individuals and businesses, the exchange will start running TV, radio and magazine ads in mid-June. The ads are expected to cost up to 11 million dollars.

Policies will be available for purchase in October, but won't go into effect until next January.

Tea party activist David Adams is currently suing Governor Steve Beshear over his creation of the exchange.

The planned expansion of Kentucky's Medicaid program coupled with a push to help the uninsured obtain health coverage could exacerbate the state's shortage of physicians, according to a report released Wednesday.

Deloitte Consulting, a technology firm that's helping to set up the Kentucky Health Benefit Exchange, unveiled the report showing Kentucky's 10,475 primary care physicians and specialists are far short of the actual need.

However, the firm concluded that Kentucky would need to find ways to increase the number of doctors and other medical professionals even if it didn't expand medical coverage to more than 600,000 new patients.

After months of deliberations, Kentucky Gov. Steve Beshear has decided to expand Medicaid in Kentucky under the Affordable Care Act, also known as Obamacare—a move that's won praise from Democrats and health advocacy groups.

Beshear said Thursday that expansion benefits Kentucky in many ways.

"This move makes sense not only for our health but also for our pocketbook. More important it makes sense for our future," he says.

The expansion will insure more than 308,000 Kentuckians. And according to studies done by PriceWaterhouseCoopers and the Urban Studies Institute at the University of Louisville, Medicaid expansion would bring about $800 million to Kentucky between next year and 2021.

Beshear says critics of the expansion are more worried about politics than good policy.

"They express vague and broad anxieties about costs, fears which the facts refute and they fall back on partisan national politics. If Kentucky expands Medicaid they ask, won't Kentucky be supporting Obamacare, they ask. Well to them I say, Get over it," he says.

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