Health Politics

Medicaid advocates, family members and policy experts gathered in Frankfort Monday to weigh in on proposed changes to the state-run insurance program for low-income and disabled people.

Kentucky’s Medicaid program was expanded by former Gov. Steve Beshear under the Affordable Care Act. But current Gov. Matt Bevin has said the costs associated with the program aren’t sustainable, and is asking the federal government to approve a plan to scale it back.

The base Medicaid program only included disabled people and people with children living in poverty, but under the expansion, single people without children earning up to about $15,000 a year could get coverage, too.

Bevin’s proposed changes include monthly payments or copays to keep coverage, a six-month lockout period for not making those payments, and a volunteer or work requirement.

The changes would mainly affect people living in poverty or slightly above.

Amy Luttrell is the president and CEO of Goodwill Industries of Kentucky, and was appointed by Bevin to serve on the Kentucky Workforce Innovation Board. She said she sees the governor’s proposed work and volunteer requirement as a way to get more people into the workforce.

“What made it possible for us to endorse is that many populations have been excluded from the new requirement, including people who have a disability, people who are primary caregivers and other people for whom work is not realistic at the present time,” Luttrell said.

But many more people at the hearing spoke against the changes. While the state plans to recruit volunteer organizations and employers to help people find opportunities, many at the hearing said it will be hard for people working to make sure they work 20 hours a week.

Andrea Welker went to the Somerset hearing last week, and was in Frankfort for Monday’s hearing to speak on behalf of her mother.

“She would love to have a job that made enough to price her out of Medicaid,” said Welker. “She applied for so many over the years but because of her skill sets, she’s limited to retail service. She wasn’t able to find anything.”

Welker’s mom lives and works in Louisville. She gained Medicaid health insurance when the state expanded the program in 2014. But Welker said under Bevin’s proposal, the 20-hour-a-week work requirement won’t be cut and dry for many people, including her mother.

“When she goes to work, she gets there wondering if they’re going to send her home four hours early,” Welker said. “These are the kind of concerns of people who do work.”

And that concern is an important one, because if Welker’s mother and others like her don’t report a change in their hours within 10 days of that change, the state will consider it Medicaid fraud.

Meanwhile, the state says it is taking the comments gathered at the two public hearings into consideration.

Lisa Gillespie is WFPL's Health and Innovation Reporter.