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With Repeated Changes To Kentucky's Medicaid, Confusion Abounds

consult doctor on the Internet
consult doctor on the Internet

It’s been almost two years since Gov. Matt Bevin first submitted complex changes to the Medicaid program in Kentucky, seven months since those changes were approved and a couple days since a federal court struck down the changes. Over the weekend, the state announced it’s eliminating dental and vision benefits for some enrollees.

And on Tuesday, another thing to keep up with: the administration announced that co-pays for doctor’s appointments and medicines were not part of the court ruling, so those will stay in place effective July 1.

It’s confusing for many enrollees, no matter if the changes – called Kentucky HEALTH – affect them, or not. At a Monday morning press conference held by Democrats rallying against the state’s latest decision, a man named Micah stepped up to ask a question.

“My name is Micah, and I’ve been on Social Security for a long time. I live on disability and I feel like, hoping that it doesn’t affect me,” he said. “That’s the question I want to ask, do you think it’ll affect the people on disability Social Security?”

The answer to his question is no. He was never going to be affected by all these Kentucky Medicaid changes because he receives Medicaid because of his disability.

But that confusion about the Medicaid changes is common. Numerous listeners and readers have emailed and called with questions. Some have said they don’t want to share their names because some assume they qualify for Medicaid because of laziness or inability to get a better job.

'It can change in a weekend'

Therese Hutton-Crump’s adult son, Ryan, gained Medicaid insurance after the state started covering some adults without dependents.

Ryan has severe asthma, high blood pressure and other health conditions. He can’t work because of them, and Hutton-Crump takes care of managing his finances and insurance. So, she’s been following the Medicaid changes really closely.

“When you get information, it’s like you have to triangulate the information for accuracy, and then it can change in a weekend,” Hutton-Crump said.  “You feel like you need to be hyper-vigilant to keep track of it.”

She knew that under the state’s original plan, Ryan was going to have to make monthly payments — premiums — to keep coverage. And she knew that certain Medicaid enrollees were going to have to work, volunteer, or do job training for 80 hours a month in exchange for insurance. But she says it was never made clear how — or whether — those changes would affect Ryan.

Hutton-Crump says she got get a letter in the mail spelling out the changes, but it was only a paragraph long. And it called the community engagement requirement “Partnering to Advance Training and Health,” or PATH, which confused her, too. Ryan may qualify for an exemption from that PATH requirement if a doctor designates him “medically frail,” but Hutton-Crump says she got the impression from the state’s consumer website that only people with severe medical conditions would qualify.

Now, Hutton-Crump is relieved that her son still has medical coverage, even though as of Sunday he’s lost access to vision and dental insurance.

“I think it’s important, but I thought well, the expense for that out of pocket is far less than for treating the asthma and the heart condition,” Hutton-Crump said.

But Hutton-Crump is scared that Medicaid expansion is going to be completely eliminated. That’s what Governor Matt Bevin has said he would do if the court decision to strike down the community engagement requirement.

Lisa Gillespie is WFPL's Health and Innovation Reporter.

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