From Rep. Lew Nicholls
Kentucky’s Medicaid expansion has been good for us.
Since the 2014 implementation of the Kentucky health exchange known as kynect and Kentucky’s Medicaid expansion under the federal Affordable Care Act, the state’s uninsured rate for its nonelderly citizens has fallen 12 percent—from 18.8 percent in 2013 to 6.8 percent in 2015—and over 439,000 adults have received coverage through Medicaid. Thousands of these new Medicaid recipients are right here at home, where enrollment in the program has grown by over 3,493 people in Greenup County and 4,985 people in Boyd County in the past two years.
This same success has been seen across the entire 4th Congressional District where the percentage of uninsured individuals has fallen 4.5 percent since 2013, from 12.4 percent in 2013 to 7.9 percent in 2014. That’s success!
Most of these newly insured neighbors are working adults who now have fewer sick days and more income because they can spend more time on the job. They work in food service, sales, construction, production, health care, office administration, personal care and support and other fields that keep our communities strong. Expanded coverage under the ACA and Medicaid expansion gives them the support they need in return.
Now that coverage is threatened.
Besides carrying through with his plans to dismantle kynect, Governor Matt Bevin is seeking a federal waiver to replace expanded Medicaid in the state with a new program called Kentucky HEALTH. The waiver would not change coverage for many traditional Medicaid enrollees (the aged, blind and disabled) but would create a new program for nondisabled adults and children including those covered before the Medicaid expansion, pregnant women, children, medically frail adults and those 400,000 plus adults who joined Medicaid under the expansion. All of these groups except for pregnant women and children covered under traditional Medicaid and KCHIP would be subject to premiums or copays with a work requirement added for non-medically frail adults and non-pregnant women and children, unless the person subject to the work requirement is a primary caretaker of a dependent. Adults who were added to the state Medicaid rolls under the expansion would also have a change in benefits, receiving state employee benefits instead of Medicaid benefits and being eligible for vision and dental benefits through a separate “My Rewards” program.
If you want to know what the proposed waiver means to those who care for Kentucky’s disadvantaged populations, you really need look no further than a statement issued on July 26 of this year by Kentucky Voices for Health, a coalition of health advocates statewide including such powerful groups as the Catholic Conference of Kentucky, Campaign for Tobacco-Free Kids, American Lung Association, Family Health Centers and many others. They stated collectively that, “Governor Bevin’s proposed 1115 waiver puts Kentucky’s successful Medicaid expansion and the coverage of nearly half a million Kentuckians at risk. It will mean less coverage and more barriers for the most vulnerable Kentuckians, including veterans, people with disabilities, … low income workers and families. It would be a giant step backwards for Kentucky.”
If you want to know what the proposed waiver means to those thousands of new non-disabled adults added to the Medicaid rolls in our counties under the expansion, well, we already have the answer: high premiums or copays, fewer benefits and other means tests.
If you want to know what the proposed waiver means to the future of Kentucky Medicaid, one answer can be found on a fact sheet titled “Proposed changes to the Medicaid expansion in Kentucky” published by the Henry J. Kaiser Family Foundation. The fact sheet states: “Projected Medicaid enrollment will decrease over the five year waiver period due to beneficiary noncompliance with program requirements, such as premium payments or employment.”
So, Kentucky has a choice. We can look out for our neighbors—the hundreds of thousands of already hard-working Kentuckians who benefit from expanded Medicaid–by offering them the coverage they need to stay well and earn an income, or we can look the other way. I think we need to look upward and keep Kentucky moving ahead, toward a brighter future for us all.
Please, let your voices be heard on this matter. Contact Governor Bevin through his official website at http://governor.ky.gov/Pages/contact.aspx and tell him what you want for your neighbors and for all of Kentucky. I’ll talk to you soon.
Rep. Lew Nicholls
98th District State Representative
