Report: Kentucky's Medicaid Changes 'Overwhelmingly' Unpopular

Aug 28, 2018

Kentucky’s proposed Medicaid alterations were widely panned during a 30-day public comment period, according to the Kentucky Center for Economy Policy

Credit AP File Photo

Analysts with the left-leaning think tank combed through and catalogued 9,300 unduplicated comments (out of 11,561 total submissions) about the Bevin’s administration’s hotly-contested 1115 Medicaid waiver, separating them into four columns – supportive, unsupportive, mixed, and unrelated.  

Tossing out the latter two, Pugel says the final tally left no room for doubt. 

"The ratio was 20-1 against the waiver," the policy analyst reports. "And that to me marks a striking representation of how deeply unpopular this waiver is." 

Pugel says respondents often displayed a sophisticated understanding of the complicated proposal, delivering a near record amount of feedback to the department. 

"In the waiver, people talked a lot about how they were worried about what would happen if they lost their coverage. These changes had a lot of people reflecting on the ways that Medicaid already helps them. There were stories after stories about loved ones benefitting from Medicaid," he adds.  

Kentucky’s own internal estimates suggest up to 95,000 people could lose coverage in five years under the plan.

The Bevin administration won approval for the Medicaid overhaul from the U.S. Department for Health and Human Services but hit a roadblock in court when a federal judge ruled against the changes. Pugel says it’s now up to the department to examine the new comments, and accept, reject, or modify the waiver.

"HHS is going to have to be very clear in either rebutting these comments and saying 'No, we don't think your concerns are warranted and here's why,' or they're going have to ask the state to make changes to adapt to the comments that were made," Pugel explains.

The analyst says most expect the department to dismiss the comments and reapprove the waiver, likely setting off another round of litigation. 

Despite the legal upsets, including a recent federal court decision dismissing Bevin's lawsuit seeking a favorable ruling on the legality of the state's Medicaid program, the administration is moving forward with the regulatory framework for the overhaul. 

Doug Hogan with the state Cabinet for Health and Family Services told the Associated Press that it's imperative the waiver be reapproved "in order to create better health, wellness, education, and employment outcomes for our recipients and create sustainability for the Medicaid program." 

The Bevin administration maintains the expansion ushered in under his predecessor, Democrat Steve Beshear, is too costly to maintain as is and the overhaul is necessary to rescue the program. The waiver attracted national scrutiny over its inclusion of work, volunteer, and job training requirements. 

Roughly 400,000 Kentuckians gained health coverage under the expansion.