A nonprofit publication of the Kentucky Center for Public Service Journalism

Commentary: Some issues addressed in revised Medicaid waiver, but concerns remain


By Susan Zepeda
Special to KyForward

The Foundation for a Healthy Kentucky is closely reviewing the revised HEALTH Medicaid waiver proposal and evaluating it through the lens of our original comments. The proposed changes could have a substantial impact on low-income Kentuckians, providers, and the state as a whole.

On a first reading of the proposal, we find that some of the concerns expressed in our initial comments have been addressed, while others remain. We are pleased that the term ‘medically frail’ is better defined and that this population is excluded from paying premiums and copayments. We are also pleased to see that there is a cap for family premiums.

In regard to work requirements, we are glad to see that individuals who are already working more than 20 hours per week will not be required to perform community service or other job training activities as a condition of continued enrollment.

Additionally, we support the exclusion of primary caregivers of disabled adult dependents from the community engagement and employment requirement, and the inclusion of a provision that primary caregivers of elderly parents will count toward that requirement. Further, we applaud the administration’s inclusion of GED testing costs.

We remain concerned, however, about a number of elements that are unchanged in the proposal, including the exclusion of dental and vision benefits in the standard benefits package, anticipated significant drops in Medicaid enrollment, elimination of retroactive eligibility, lock-out periods, loss of non-emergency transportation, and re-enrollment requirements and penalties for those who fail to pay mandated premiums.

We encourage stakeholders to review the documents the state has prepared and to submit public comments during the federal comment period.

Zepeda, Susan (1)

Susan Zepeda is president and CEO of the Foundation for a Healthy Kentucky


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