Kentucky officials say they expect the Trump administration to approve their request to overhaul the state's Medicaid program following multiple failed efforts in Congress to slash the expensive health care system.
With nearly 500,000 people added to Kentucky's Medicaid rolls under a provision of former President Barack Obama's health care law, Kentucky's Republican governor vowed to end that part of the program if the federal government did not give him permission to make significant changes.
That was more than a year ago, and Gov. Matt Bevin is still waiting for an answer. So are the state's Republican lawmakers, who are trying to figure out how to rescue a public pension system that is more than $30 billion in debt while grappling with a projected $155 million budget shortfall.
On Thursday, officials with Bevin's Health and Family Services Cabinet assured state lawmakers they expect the Trump administration to approve their plan.
"Our conversations with (the federal government) are moving in the right direction so we feel very confident about that approval," said Veronica Cecil, deputy commissioner for the Department of Medicaid Services.
Kentucky is one of five states with pending applications to change their Medicaid programs. Bevin's plan, if approved, would be the first time the federal government has allowed a state to require Medicaid recipients to have a job or perform some type of community service in order to keep their health coverage.
Critics say the plan would make it much harder for poor people to have access to health care. But Bevin says it would put more people to work, eventually reducing the number of people on Medicaid and saving the state money. Since expanding the state's Medicaid eligibility in 2014, Kentucky's costs have increased by more than $467 million. The overall cost of the program has increased by $4 billion, with more than 77 percent of that money coming from the federal government.
Bevin's plan estimates that, by 2021, the state will have 95,000 fewer people on Medicaid. Democratic state Rep. Joni Jenkins says she hopes Bevin is right in that all of those people will have gotten jobs that allow them to purchase private insurance plans. But she said she is afraid that is not realistic.
"We're paying for sick people, one way or the other," she said. "Paying for someone to have a colonoscopy every 10 years is a lot cheaper than treating somebody with colon cancer."
