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Bevin Teams With Nonprofit To Implement Kentucky Medicaid Changes

Cabinet For Health and Family Services/Screenshot

Ahead of the July 1 start date for changes to Kentucky’s Medicaid program, Gov. Matt Bevin has announced a partnership with the Foundation for a Healthy Kentucky to help educate enrollees on new requirements and assist some in making mandated payments to keep Medicaid insurance.

The Foundation for a Healthy Kentucky, which primarily works to push health-related issues through Frankfort and commissions health studies, will create a separate foundation to run the Medicaid outreach.

“It is going to take a localized, almost grassroots effort to try to help Medicaid beneficiaries navigate all the requirements,” said Veronica Judy Cecil, who was hired by the Foundation  to oversee the initiative. Until recently, Cecil was deputy Medicaid commissioner at the Cabinet for Health and Family Services.

Cecil said they are starting to look for community organizations across the state to help people maintain coverage.

“Our hope is that they will step up and work with us," Cecil told WFPL. "We all share that common goal. We want people to have access and we want them to have better outcomes. I think if we all work toward that goal, regardless of how we feel about [the Medicaid changes], we will achieve that.”

Controversial Changes

In 2016, Bevin submitted the state's final Medicaid waiver to the federal government. In January of this year, the Trump administration approved Kentucky's Medicaid changes.

One of the most controversial changes to the state's Medicaid program is the addition of a work requirement, or "community engagement" hours, in order to maintain coverage. Several advocacy groups are suing the federal government on behalf of 15 Kentuckians who are enrolled in Medicaid, saying that Kentucky’s recently approved Medicaid changes violate the Social Security Act.

Bevin has said he will take away Medicaid expansion coverage from about half a million Kentuckians if a court blocks any of the approved changes.

The community engagement requirement calls for "able-bodied" adults to do 80 hours a month of work, training, education or some other activities in order to keep their Medicaid coverage. This includes not only the expansion population but also some Kentuckians who had Medicaid prior. Former foster care youth, "medically frail" adults, pregnant women and kids are exempt from the requirement.

“We will help build and coordinate support services and opportunities so beneficiaries can get the 80 hours of monthly work or other community engagement hours they need,” said Ben Chandler, president of the Foundation for a Healthy Kentucky.

The Foundation is not receiving funding from the state for the project, and Cecil said unless they have funding they aren’t planning on giving community assisters money for their efforts to help Medicaid enrollees keep coverage.

“I think there are a lot of different people out there that want to see this be successful, and want to ensure that Medicaid beneficiaries retain coverage,” Cecil said. “So we’ll start to do some fundraising, and with those funds we’ll have to see what’s the best use of that money.”

At the Wednesday event announcing the partnership, Bevin said officials from several other states have visited Kentucky to see how implementation is going. He called the Medicaid changes an experiment, and said results will show up in nationwide health rankings that consistently place Kentucky's overall health at 49th or 48th in the nation.

“Their likelihood of obtaining success — success being engagement in their own health and ultimately a better health outcome — that no matter which door they come through will end up with a better result," he said.

Adam Meier, secretary of the Cabinet for Health and Family Services, said the state is collaborating with researchers from the University of Pennsylvania. Researchers will study 35,000 Kentuckians who would otherwise have to meet the new requirements but will be exempt as part of the study. Researchers will study the outcomes of this group against the outcomes of people who will not be exempt from the requirements.

“We’re actually doing a randomized control trial as part of the monitoring and evaluation plan that would hold up to scientific scrutiny so we can measure the outcomes,” Meier said.

The state will implement the community engagement requirement in July in Campbell County in northern Kentucky. In the following months, the state will implement the requirement in other regions of the state.

Premium payments, loss of automatic dental and vision benefits, loss of non-emergency transportation and other requirements will begin in July for all of Kentucky.

“I’m being realistic. Again with July 1 quickly approaching, we’re optimistic. But we’re also realistic. We’ve said from the beginning that we’re going to do our best effort and take that as far as we can go with it,” Cecil said.

Lisa Gillespie is WFPL's Health and Innovation Reporter.

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