A nonprofit publication of the Kentucky Center for Public Service Journalism

Bevin declines to join governors’ group call for continuation of formula used to fund state Medicaid

By Al Cross and Melissa Patrick
Kentucky Health News

A bipartisan group of governors, including Kentucky Gov. Matt Bevin, is asking Congress not to shift health-care costs to the states, a real prospect as the Senate prepares to vote on a bill to repeal and replace the Patient Protection and Affordable Care Act.

However, Bevin declined to join the group’s request to maintain federal funding rates for Medicaid, the program that covers 1.4 million Kentuckians and is in for big changes if Senate Republicans’ health bill becomes law.

Gov. Matt Bevin

Bevin and Kentucky are part of the Governors’ Bipartisan Health Reform Learning Network, organized by the National Governors Association Center for Best Practices.

It has six Republican and seven Democratic governors from California, Delaware, Kentucky, Minnesota, Montana, Pennsylvania, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington and Wyoming.

The governors summarized their priorities Wednesday, as details of the Senate bill were leaking out. It would end the Medicaid expansion later than a bill passed by the House, but would use a less generous formula for funding state Medicaid programs, beginning in 2025.

A statement of “shared priorities” from the 13 governors in the network says, “It is critical that Congress . . . not shift costs to states. Significant cuts to Medicaid will impact coverage for millions of low-income individuals and could impede state efforts to address the underlying factors driving health care costs.”

It also said, “For the majority of the network states that expanded Medicaid, maintaining coverage for those populations at the federal matching rate under current law is of critical importance. (With the exception of Kentucky which does not agree with this statement).”

Bevin’s predecessor, Democrat Steve Beshear, expanded Medicaid to people in households with annual incomes up to 138 percent of the federal poverty level. The federal government paid the full cost of the expansion until this year. It is now paying 95 percent, which will drop in annual steps to the current law’s floor of 90 percent in 2020.

For traditional Medicaid patients, the federal government pays about 70 percent of the costs, based on a formula that gives poorer states higher reimbursement rates.

The governor’s office didn’t immediately respond to a request for comment on why Bevin declined to support this part of the statement. During his 2015 campaign, Bevin initially said he would abolish the expansion, and even after dropping that idea, said federal money shouldn’t be accepted just because it is available, because it is taxpayer money.

Under the bill revealed Thursday, Medicaid funding would use “an even slower growth index than the one used in the House bill,” reports Paige Winfield Cunningham of The Washington Post. “That move could prompt states to reduce the size of their Medicaid programs.”

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