Medicaid battle brewing: Gov. Matt Bevin's ultimatum to challenge feds

Kentucky Gov. Matt Bevin speaks to town hall attendees in New Hampshire. (Photo: Gage Skidmore)

Kentucky Gov. Matt Bevin’s plan to revamp the state’s Medicaid program is setting the stage for a standoff between the conservative politician and federal health officials.

Bevin, who ran on a platform of scaling back Medicaid expansion and closing the state’s exchange, now wants to overhaul the program. His plan, called Kentucky HEALTH, would require non-disabled beneficiaries to obtain jobs in order to receive benefits and ask them to pay small premiums into the program.

Bevin explains in his proposal that while the state ranks first in the nation for Medicaid managed care profits, health outcomes are still poor. He says his plan would keep the state’s Medicaid program fiscally sustainable.

Bevin’s plans have proved controversial, as Kentucky’s Medicaid expansion helped the state reduce its uninsured rate from more than 20 percent in 2013 to 7.5 percent last year, Kaiser Health News reports. Former Democratic Gov. Steve Beshear, one of the more vocal critics to Kentucky HEALTH, created the nonprofit group Save Kentucky Healthcare to advocate against Bevin’s platform.

Susan Zepeda, the CEO of another advocacy group, the Foundation for a Healthy Kentucky, argues in a recent op-ed featured in the Courier-Journal  Bevin’s plan would “create more barriers for low-income Kentuckians and likely make the state’s health--and health disparities--worse.”

Bevin is expected to apply by Aug. 1 for a waiver that exempts the state from Centers for Medicare & Medicaid Services rules that prohibit tying Medicaid coverage to a work requirement, according to KHN. He has threatened to completely unravel the state’s Medicaid expansion if the Obama administration rejects his plan.

A Department of Human and Health Services spokesman tells KHN that the agency hopes Kentucky will opt for a path that doesn’t lead it to “go backwards” from progress achieved through expanding Medicaid. The administration allowed Indiana to test a similar Medicaid expansion strategy, but only after it scrapped the requirement that Medicaid recipients to hold jobs.

- read the KHN article
- here’s Bevin’s plan
- read the Courier-Journal op-ed