A nonprofit publication of the Kentucky Center for Public Service Journalism

Delays announced to implementation of parts of Bevin administration’s Medicaid waiver

By Tom Latek
Kentucky Today

Some parts of the Bevin administration’s implementation of the Medicaid waiver that was granted by the federal Centers for Medicare and Medicaid Services, or CMS, are being delayed.

The Cabinet for Health and Family Services on Thursday released updated guidance regarding Kentucky HEALTH, which was re-approved in November by CMS.

Kentucky HEALTH, an acronym for Helping to Engage and Achieve Long Term Health, was approved by the federal CMS last year, but a federal judge had halted implementation of the waiver program on June 29, just two days before it was to begin, due to a lawsuit filed by 16 Kentuckians.  Those same 16 have filed a lawsuit against the re-approved waiver.

CHFS Secretary Adam Meier

According to the Cabinet, on April 1, Kentucky HEALTH will begin with many Medicaid beneficiaries being moved to the Alternative Benefit Plan, in which they will access certain vision and dental services through the My Rewards Account.  Currently, more than 480,000 beneficiaries have already accrued over $70 million in My Rewards dollars that they can use for these services.

While most Kentucky HEALTH members will be moved into the monthly premium payment plan on April 1, all Kentucky HEALTH premiums will be waived for the month of April.  This will give beneficiaries an opportunity to become familiar with the program prior to being required to make their first monthly premium payments.

While the start of the community engagement requirement that is part of the condition for able-bodied Kentuckians to continue receiving Medicaid benefits is still being finalized, CHFS has established that it will begin no sooner than July 1.  The requirement could be accomplished through such things as employment or job training, school and community service.

The Department for Medicaid Services has been working with the economists in the Office of the State Budget director to update the Medicaid budget projection due to significant declines in the number of Medicaid enrollees since June of 2018.  At that time, Medicaid enrollment was in line with previous projections and there was an estimated $295 million state general fund shortfall in the Medicaid budget projected over the current biennium.

During the last three quarters of calendar year 2018, there was a 72,309 decline in overall Medicaid enrollment.  Using updated enrollment data and revenue projections, DMS and OSDB now estimate that, based upon current Medicaid enrollment levels and assuming continuing economic conditions, the enacted budget will now be sufficient to cover expenses over the current biennium.

“As the economy improves and more jobs are created, tens of thousands of Kentuckians are moving from Medicaid to private insurance through their employers or the marketplace,” said CHFS Secretary Adam Meier.  “This underscores the growing opportunities for Kentuckians to find good-paying jobs, the demand for a healthy, skilled workforce, and the critical role Kentucky HEALTH will play in connecting people to robust opportunity development resources, tuition-free job certification programs, and workforce and volunteer opportunities in their communities.”

While the new projections provide a more optimistic current outlook for the DMS budget, Medicaid Commissioner Carol Steckel offered a reminder of the need for caution in analyzing the information. 

“When Congress passed the Affordable Care Act, it changed the face of Medicaid forever,” said Steckel.  “Kentucky Medicaid, now more than ever, is subject to the fluctuations in the economy both good and bad. The current analysis is based on many significant financial and demographic assumptions that will change along with changes in the economy and other factors.”   

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