A publication of the Kentucky Center for Public Service Journalism

State Medicaid work requirements begin July 1; Northern Ky. counties first to implement changes

Kentucky’s new work requirements for “able-bodied” Medicaid recipients will be phased in slowly, with the three main Northern Kentucky counties leading the way. Campbell County will be the first to instigate the new “community engagement” requirements on July 1, followed by Boone County on Aug. 1 and Kenton County on Sept. 1.

After that, large groups of counties are to be rolled into the program each month until the last scheduled counties are added Dec. 1.

Whitley, Knox, Bell, Clay, Leslie, Harlan, Perry and Letcher counties will be exempt from the community engagement requirements until December 2019, according to Beth Fisher, a spokeswoman for the Cabinet for Health and Family Services.

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These new “community engagement” requirements are part of an overhaul of the state’s Medicaid program, part of which will require “able-bodied” Kentuckians to participate in an approved community engagement or work activity 80 hours a month, and document their hours monthly, to keep their Medicaid coverage. Officials call the program PATH, for Partnering to Advance Training and Health.

The rest of the Medicaid benefit changes will start July 1 for all counties, according to the health cabinet. Those are the deductible account, which is like a health-savings account; the My Rewards account, which allows a person to earn credits for dental and vision care; the reporting and lock-out requirements; and the premium and co-payment requirements, etc.

Click here to view a county-by-county spreadsheet of enrollment in Medicaid, as of January 2018

Kristi Putnam, program manager for the changes in Medicaid, told attendees of a recent stakeholder forum in Frankfort, “Volunteering, caregiving, job training, enrolling in classes and working are all qualifying activities,” Darla Carter of Insider Louisville reports.

The changes will largely affect “able-bodied” Kentuckians without dependents who have gained Medicaid coverage through the 2014 expansion to people in households with incomes up to 138 percent of the federal poverty level.

Pregnant women, those who are deemed medically frail, primary caregivers of a dependent, full-time student, former foster youth up to age 26 and the chronically homeless will be exempt from the requirements.

Kentuckians who qualify for the program will get a notice in the mail about the community engagement requirements, as well as the address of a Kentucky Career Center to aid them.

“We’ve been partnering with our library system,” Putnam said. “We’ve been working with our federally qualified health care centers to find other locations and other places where career coaches can go and actually provide services, so job assessments, job placement services, connection to training and education programs, so this is intended to not be a you have to come to the career center. It’s very much intended to be we will come to where you are.”

Putnam added that the slow rollout is designed to help the state troubleshot and allow for weekly meetings to discuss any issues that arise, Carter reports.

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The state recently rejected a request by a consumer advocacy group that has voiced concerns about the changes, Kentucky Voices for Health, to create a stakeholders advisory council to help with the implementation of the program, Carter reports. (KVH has created two “explainers” about the changes, one in two pages, and a more detailed version in four pages.)

WFPL, a public radio station in Louisville, has also created an interactive tool called “Kentucky Medicaid Waiver Calculator,” to help Medicaid enrollees and others figure out how it will affect them, based on family size, income, and other factors. The state does not support its use.

Instead, the state has opted to continue with its current approach, which includes holding forums and sending beneficiaries notices in the mail, Carter writes.

The next forum is scheduled for June 7 at 1 p.m. at the Kentucky Career Center, 1324 Madison Ave. in Covington.

In addition, the state offers its own overview that includes answers to frequently asked questions; it is online at kentuckyhealth.ky.gov.

The state also offers a website, citizenconnect.ky.gov, where Medicaid beneficiaries can go to report and check in on their benefits, track their monthly program requirements and earn or spend their rewards from their My Rewards account.

The changes are being challenged in federal court in Washington by 16 Kentuckians on Medicaid who say the waiver approved by the Trump administration violates several federal laws. They also argue that the waiver risks the health care of tens of thousands of low-income families.

The administration of Gov. Matt Bevin has estimated that in five years, the Medicaid rolls would have 95,000 fewer people with the changes than without them, partly because of non-compliance. The program covers about 1.4 million Kentuckians.

From Kentucky Health News

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