Bevin Submits Revised Ky. HEALTH Plan

Aug 24, 2016

Credit governor.ky.gov

 Gov. Matt Bevin says he has changed his proposal to overhaul the state's Medicaid program and submitted it to the federal government for approval.

The new proposal called Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) will cover allergy testing and private duty nursing for about 400,000 Kentuckians who have health insurance through the state's expanded Medicaid program under the federal Affordable Care Act.

People who are in hospice care, have HIV or AIDS and receive federal disability benefits will also not have to pay premiums or copays. The elimination of automatic dental and vision benefits will be delayed by three months.

People can still get those benefits by earning credits in a ‘My Rewards Account’ by doing things like earning a GED and having a health assessment.

Bevin said his administration received nearly 1,350 public comments on the proposal.

CMS has 15 days to acknowledge the waiver has been submitted. There will then be a 30 day federal comment period, after which the Secretary of Health and Human Services has authority to approve the waiver.

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Per a news release here are some of the changes listed:

Highlights of those changes include:

  • In response to the topic that received the most comments by far: allergy testing and private duty nursing will continue to be covered services.
  • The implementation of changes to the dental and vision benefit will be delayed by three months to allow members additional time to accrue funds in their My Rewards Account.
  • Individuals determined “medically frail” will be exempt from required premiums and copayments.
  • GED testing costs will be added as an additional covered benefit for Kentucky HEALTH members.
  • The list of activities resulting in contributions to the My Rewards Account will be expanded to include caretaking responsibilities, passing the GED and ensuring children receive recommended preventative services, like immunizations. 
  • Sliding scale premiums will be collected on a household basis (not individual basis).

In addition, several existing policies were clarified to address misconceptions in the public comments:

  • Benefits will not change for children, pregnant women, medically frail and adults eligible for Medicaid before expansion.
  • Full-time students or individuals working more than 20 hours per week are already meeting the community engagement and employment requirements.
  • Smoking cessation benefits are not reduced under the waiver.
  • Disabled individuals receiving waivers or SSI will not be impacted by the waiver.

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Response from Kentucky Youth Advocates:

In a response by Kentucky Youth Advocates, Dr. Terry Brooks said while they appreciate the modifications, they still have some concerns. The new plan does not include former foster youth up to the age of 26 in the waiver and options to gain rewards through activities (like a parent taking a child to the doctor) - both were changes they advocated. Their concerns include low income individuals still subject to copayments and premiums they cannot afford, that individuals without job growth potential not able to pay increasing monthly premiums and that vision and dental services are considered an 'earned benefit.' Kentucky Youth Advocates is a nonprofit children's advocacy organization.