Health

Starting this July, Kentucky will start making some Medicaid enrollees work, volunteer, take classes or train for jobs in order to keep health care coverage. Last week, the federal government approved the long-awaited Medicaid waiver that Governor Matt Bevin submitted in the summer of 2015.

The waiver includes several changes to Medicaid, and the bulk of these changes will affect people who received coverage under the expansion of the program made possible by the Affordable Care Act. Here’s how many people in each of Kentucky’s counties fall into that group:


Other people potentially affected by the changes are so-called ‘able-bodied’ adults who make under 100 percent of the poverty limit.

Kentucky is the first state that will make some Medicaid enrollees fulfill community engagement requirements – which some are calling ‘work requirements – to keep their coverage. This requirement means an enrollee has to work, volunteer, take GED courses or do other activities at 80 hours a month, or lose coverage.

What’s new:

  • A community engagement requirement for 80 hours a month or loss of coverage.
    • Who has to do this?
      • The Medicaid expansion population, or people who make between $12,061 and $16,642 for one person.
      • The ‘traditional’ Medicaid population: People who qualify for Medicaid because they earn $12,060 or less (the poverty level).
    • People that don’t have to do this:
      • Former foster care youth, ‘medically frail’ adults (Kentucky hasn’t started making determinations on this group), pregnant women and kids.
  • Co-pays at doctor’s visits, or monthly premiums (premiums will be only way to earn points to dental and vision coverage)
    • Who will this affect?
      • Medicaid expansion adults
      • Medically frail adults and former foster care kids (up to age 26) will have to pay the monthly premium to be able to earn points for vision and dental services.
      • Pregnant women, the traditional Medicaid group and kids don’t have to pay these.

People that qualify for Medicaid because they receive Supplemental Security Income won’t see any changes to the coverage they already have. SSI is for people with low-incomes and limited assets who are either aged 65 or older, blind or disabled.

People who have Medicaid but also Medicare are excluded, as well as people living in a nursing home. Also excluded from Bevin’s waiver are people who are on numerous specialized programs in Medicaid, including people with a Home and Community-based Waiver, the Michelle P. Waiver, Acquired Brain Injury Waiver, and the Supports for Community Living Waiver.

 

Lisa Gillespie is WFPL's Health and Innovation Reporter.
Alexandra Kanik brings the numbers to life as the data reporter for WFPL News and the Ohio Valley ReSource.