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Kentucky HEALTH means a healthier state

By Governor Matt Bevin

On Dec. 30, we started the process of transforming Kentucky’s Medicaid program to produce better health outcomes, while ensuring the program’s long-term fiscal sustainability. At the same time, we are working to improve community involvement and restore dignity to Medicaid recipients by engaging them more fully in making decisions about their own health care.

Kentucky is hurting. Twenty percent of our residents live in poverty; we are 47th in the nation for median household income; nearly one-third of Kentuckians are on Medicaid and our workforce participation is among the worst in the nation at less than 60 percent. In addition, our Commonwealth faces significant budget issues, including fixing the most underfunded state pension plan in the country.

Kentucky must transform its Medicaid system immediately. Beginning next year, we will be required to start paying a portion of the costs of Medicaid expansion for the first time. This is expected to cost Kentucky taxpayers approximately $1.2 billion in new spending for fiscal years 2017 through 2021. These costs create funding issues that jeopardize coverage for our traditional Medicaid program which, itself, is projected to cost Kentucky taxpayers $9.5 billion over the same period, as well as putting other state programs such as education, pensions and public safety at risk.

Many politicians take as a matter of pride the number of people that have been covered under the Medicaid expansion. However, simply increasing a public program that has not historically demonstrated an impact on improving health outcomes does not equate to success. Kentucky HEALTH is designed to engage individuals in improving their health, investing in their communities and preparing them to be independent of public assistance.

Federal Medicaid policy has long supported employment for individuals with disabilities, recognizing that “employment is a fundamental part of life.” Research also indicates that community engagement and work can improve health. Kentucky HEALTH seeks to demonstrate the application of these principles to an able-bodied population, by requiring individuals to engage in work, job search and training activities or to volunteer in their communities.

Kentucky HEALTH also restructures current coverage into a consumer-directed health plan consistent with our state employees’ plan. Kentucky HEALTH requires participants to pay affordable monthly premiums, starting at only $1 per month, to ensure individuals have “skin-in-the-game” and to familiarize them with private coverage concepts. Each participant will be responsible for managing a deductible account to fund initial medical expenses, and leftover funds can be directed to their “My Rewards Account,” an innovative new feature provided to all participants making their monthly premium contributions.

Participants can earn money for their My Rewards Account by completing activities such as disease management classes, community service, smoking cessation programs, financial literacy programs or job search and training activities. The money in the account can be used to fund additional benefits such as dental, vision, over the counter medications or reimbursement for the purchase of a gym membership. If participants leave the program and secure private insurance for 18 months, they can keep the remaining balance of this account up to $500.

Like any other health insurance program, when a participant doesn’t pay their premium, there are penalties. The penalties are intended to prepare individuals for the realities of commercial coverage. The penalties vary based on federal poverty level, but they have a corresponding “on-ramp.” Individuals that take a financial or health literacy class and begin paying their premiums can get back on the plan.

Included in our health care reforms, Kentucky HEALTH will also address Kentucky’s drug abuse epidemic by continuing enhanced benefits for substance abuse and mental health services. In addition, we will be developing a pilot program for select high-risk counties to improve access to treatment.

We will align various Kentucky HEALTH components to support our Commonwealth’s existing public health infrastructure and current efforts to address chronic disease prevention and management. Lastly, we will introduce delivery system reforms to ensure that Kentucky taxpayers are getting the best value for their investment, including measures incentivizing providers to improve quality and outcomes.

Recently, we toured the state to hear from Kentuckians face-to-face about how our proposed changes might affect them. We have also been collecting written comments from all over the commonwealth, and we are using that feedback to help us make an even stronger waiver application.

It is of no value for current and former politicians to simply brag about Medicaid expansion without actually improving health outcomes or providing a plan to pay for its costs. We owe it to our families and our communities to offer a health care program that will improve quality of life and equip individuals to enter commercial insurance with the knowledge and confidence they will need to be successful.

Kentucky HEALTH is innovative and necessary. It empowers individuals and creates a platform for shared responsibility in improving their own health. I look forward to federal approval of our waiver application so Kentucky can implement a plan designed to meet the specific health care needs of our citizens and ensure the long-term sustainability of our entire Medicaid program.

The basic human dignity of Kentuckians and the prudent stewardship of taxpayer dollars deserve no less.


Last week we took a look at how fact checkers rated statements made in speeches at the Republican National Convention. This week we look at the Democratic National Convention. If you want to re-publish them, we encourage you to look at reports by The Washington Post's Fact Checker unit, PolitiFact and for full context and things you may want to add. (CBS image: Sen. Kirsten Gillibrand (D-N.Y.))

One of the biggest issues on Monday was minimum wage, which was brought up at least three times. Sen. Kirsten Gillibrand (D-N.Y.) said, “Donald Trump actually stood on a debate stage and said that wages are ‘too high’.” Sen. Bob Casey (D-Pa.) said, “This November, we have a choice. You can choose a candidate who’s only out for himself, who wants to get rid of the federal minimum wage, and who would cut taxes for the richest Americans at the expense of the middle class.” Sen. Elizabeth Warren (D-Mass.) said, "Trump wants to get rid of the federal minimum wage.”

Post fact-checkers Glenn Kessler and Michelle Ye Hee Le write, "Trump has made contradictory statements on the minimum wage, so here is some necessary context to the claims by Gillibrand, Casey and Warren. During a November 2015 Republican primary debate, Trump was asked whether he was 'sympathetic to the protesters cause since a $15 wage works out to about $31,000 a year.'"

Trump said he couldn't be sympathetic because “We are a country that is being beaten on every front economically, militarily. . . . [With] taxes too high, wages too high, we’re not going to be able to compete against the world. I hate to say it, but we have to leave it the way it is. People have to go out, they have to work really hard and have to get into that upper stratum.”

Kessler and Lee write, "Days later, Trump clarified he was referring to whether he would increase the minimum wage. He would not raise it, because then it would be 'too high,' he said. Then in May 2016, Trump appeared to support states' raising minimum wages, and to oppose the federal government setting a floor on wages for states to raise. Trump also said that he didn’t 'know how people make it on $7.25 an hour.' But Trump has indicated since then that 'he might be willing to trade a minimum-wage increase to obtain another policy goal,' The Wall Street Journal reported on July 19."

On other questionable claims, Robert Farley of writes, "Sen. Bernie Sanders said Hillary Clinton 'will guarantee' free tuition at public colleges or universities for families with annual incomes of $125,000 or less. But free tuition is not guaranteed. States must put up matching funds for the students to receive free tuition. Sanders also said the 'top 1 percent in recent years has earned 85 percent of all new income,' but economists whose work Sanders has cited put the figure at 52 percent for 1993 to 2015."

Written by Tim Mandell Posted at 7/26/2016 12:46:00 PM


A Penny Mentality In America?

By Glenn Mollette

I had just parked my car in a city parking lot when I heard the cries of a loud voice.

"Sir, please give me a penny! Please just a penny," he pled. I continued to walk because I do not like being verbally accosted by a stranger. I was in an unfamiliar part of town and felt spooked by his sudden appearance to plead with me for a penny.

I have been asked for a dollar hundreds of time from street beggars but never a penny. I'm thinking to myself, "Wow, how low can a guy go?" On many occasions I have handed people a couple of dollars or a five. Never have I been asked for a penny. Once my family and I stopped at a light and this man was begging for money and we gave him ten dollars. As soon as he had it in his hand he smiled saying he had enough now for a bottle of whiskey. We shook our heads and felt like fools for helping the guy.

My wife and I were once walking down Broad Street in Nashville to our favorite candy and popcorn store. We saw a woman eating a sandwich and a man pled for her to give it to him. She appeared to have eaten a bite or two from it. He took it right from her hands and ravished that sandwich. The guy was obviously starving.

You really never know who is truly suffering and who is a daily panhandler. A lot of America is on welfare and we have people sleeping on the streets or under bridges or on park benches. I hope the election this fall will bring change. We didn't get in this shape in one election. I don't see how one election will get us out of this shape we are in today. However, we must make a major stride in a different direction or we are going to lose this country. We cannot afford more welfare, more illegal immigrants, more jobs exported out of America and a weaker military. I personally think this election is America's defining moment in history. Supreme court justices will be appointed the next four or eight years that will have a major impact on the future of America.

Okay, back to the penny beggar. I seldom have a penny but I did have a quarter. I gave the man a quarter. Immediately he wanted more change. He said he wanted to buy his daughter a bottle of water. "Wait a minute sir, you said you wanted a penny." "Yes, but I need more change for a bottle of water," he pled. The man looked about 28 years old. I was beginning to think I would just hand him five or maybe even ten dollars. I then asked him, "Why aren't you working a job? " Without missing a beat he replied, "I can't work a job because I would lose my check." "What? You would lose your check?? "Yes, if I work they will take my check away from me." I then asked him how much do you receive each month in your check and he said, "Seven hundred and some dollars." "Sir," I replied, "You, could make more money if you would just work as hard as you are begging me and others for money." He actually nodded his head and agreed with me.

I did not give him any more money. Maybe I should have but His attitude of "I will not work because I prefer to subsist on government assistance has become too prevalent in America.

We cannot live on pennies and welfare in America. This is not a real life. It's time for a change in this country. It's time for real jobs to come back to America. It's time for us to defend our borders, build up our military and repair our infrastructure. We have to get off this status quo lifestyle of mediocrity and being comfortable in poverty. This is not the America our parents built. We can't go from a dollar mentality to a penny mentality because after this there is no lower to go.

Glenn Mollette is an American Syndicated Columnist and Author. He is the author of eleven books and read in all fifty states. Enjoy Books By Glenn Mollette at

This column does not necessarily reflect the view of any organization, institution or this paper or media source.


Social problems in rural areas change nature of USDA

Hillary wants to change USDA to add rural development

Pomeroy, Ohio


Al CrossThe U.S. Department of Agriculture is "becoming Uncle Sam’s lead tool to fight a social emergency -- soaring drug use, rising suicide rates and deepening poverty -- spreading across the heartland," Alan Bjerga reports for Bloomberg News.

“We’re charged with the responsibility of filling the gap to make sure rural America hasn’t been forgotten,” Agriculture Secretary Tom Vilsack told Bjerga, who reported from Pomeroy, Ohio, "a town of about 1,800 people about 200 miles south of Cleveland, where . . . the opioid epidemic has accompanied an ebbing-away of jobs and, among some demographics, an unprecedented drop in life expectancy. Any Norman Rockwell idyll of white-picket fences and unlocked front doors has long since been upended by globalization."

"Such social problems have changed the government’s conception of rural development, says Vilsack, who’s under consideration by Democratic candidate Hillary Clinton as a possible running mate. Five years ago, “We might have made a grant for a fire station,” he said in an interview. “Now it might be a substance-abuse center.” (As a candidate in 1987, Clinton said she favored renaming the Agriculture Department the Department of Agriculture and Rural Affairs.)

“Most people in cities are now several generations away from life on the farm, and some even think of rural areas as our dumping ground,” eminent Cornell University sociologist Daniel Lichter told Bjega. “It’s where we send our prisoners, our garbage and our toxic waste.”

Bjerga says USDA's role illustrates a point not often made: "The government, like the wider culture, is much more attuned to the problems of urban areas where most Americans live. That’s why Donald Trump’s message -- repeated at the Republican National Convention up the road in Cleveland, where he accepted the nomination last night -- of fighting for the small-town folks has resonated so much in rural parts of swing states like Ohio."

Dee Davis, president of the Center for Rural Strategies, told Bjerga, “When your government is based on the assumption that the country is going to be 90 percent urban, you’re going to concentrate resources on urban areas,” Davis said. “The USDA becomes the ‘rural’ agency that’s left with this wide mandate, even if it’s not always the best fit.” (Read more)

Written by Al Cross Posted at 7/22/2016 10:53:00 AM

Desperation in Appalachia and rest of rural U.S. fueled Trump's rise to Republican nomination

Donald Trump's rise from businessman and reality television star to Republican nominee for president has been fueled by desperation in some parts of rural America, Claire Galofaro reports for The Associated Press. Lost jobs, high rates of poverty and drug abuse, and limited education in some areas led to anxiety and despair. "And desperate people, throughout history, have turned to tough-talking populists. And that is how, in one of America’s forgotten corners, the road was perfectly paved for the ascent of Trump." (AP photo by Steve Helber)

Trump has been huge in Central Appalachia, winning "by spectacular margins all across the coalfields," Galofaro writes. "From Appalachia to the Rust Belt to the hollowing manufacturing towns in the Midwest, Trump collected his most ardent supporters." Trump, won big in areas like Logan County, West Virginia, where the unemployment rate is 11 percent—compared to 5 percent nationwide—and West Virginia is the nation's only state "where less than half of working-aged people work." Logan County resident Mike Kirk, who lost his home and his $28 per hour mining job, and now makes $11 in a pawn shop, told Galofaro, “He offers us hope and hope’s the one thing we have left.”

Peter Atwater, a consultant who studies the tides of consumer confidence, said "the average Republican is as pessimistic about the economy today as the day Lehman Brothers collapsed eight years ago," Galofaro writes. "That perception of decline—that the country is careening in the wrong direction—can be as politically potent as watching your hometown wither, he said." Some call those people "nostalgia voters."

Daniel Cox, research director for the non-profit Public Religion Research Institute, "said an uneven recovery from the recession lined up with societal shifts—the election of the first non-white president, a rising minority population, the decreasing influence of Christian values," Galofaro writes. "It left many in struggling, blue-collar communities across the country feeling deserted for the sake of progress someplace else." He told Galofaro, “Today, we’re not interested in the plan, we’re interested in the slogan. When confidence falls, it’s all too complicated to understand an elaborate plan or an articulated policy. We don’t want to wait for the details; we don’t want to read the footnotes. Just give me a powerful headline.”

That's something Trump excels at, Galofaro writes: "Trump promised to build the wall. Create jobs. Destroy ISIS. He blamed immigrants and China and Muslims for America’s woes. He stood on a stage in West Virginia, put on a hard hat and pantomimed shoveling coal. He promised to make them win again. His critics warn that his red-blooded, racially tinged rants threaten to unravel the very fabric of the nation. Here, the same words translate as truth-telling. His call caught fire so fervently that some are staking their families’ futures on whether he wins in November." (Read more)

Written by Tim Mandell Posted at 7/19/2016 11:44:00 AM