Health Politics

Louisville Congressman John Yarmuth is asking the federal Department of Health and Human Services for an update on Kentucky Gov. Matt Bevin’s Medicaid expansion changes.

Yarmuth wrote the letter Thursday.

Last August, Bevin proposed several changes for Kentuckians on Medicaid — both those that got their insurance through the Medicaid expansion and make up to 138 percent of the poverty level, and traditional Medicaid enrollees, which includes people living in poverty.

In an interview Thursday, Yarmuth said the Medicaid waiver was made not to improve the health of Kentuckians, but because of politics.

“The waiver was submitted last fall, and it seems to me that it’s taking them a long time, particularly since Seema Verma helped consult with Kentucky, and she’s running CMS right now,” he said. “So I’m not sure what the delay is. And I wanted to go on the record and remind them that according to Medicaid law, this really shouldn’t be approved.”

Bevin’s changes would put in place high-deductible health plans instead of the free benefits that Medicaid has traditionally offered.

The $1,000 deductible would be paid for by the state, but there would also be premiums adjusted depending on income. People with disabilities, pregnant women, children and caregivers would be exempt from that.

Enrollees would also have to re-enroll every year for Medicaid coverage as well, excluding pregnant women, children and people with chronic and serious medical, developmental or mental conditions.

Bevin’s plan, if approved, would go into effect on January 1, 2018. Yarmuth said there’s not much time left to make big system changes, or educate people about those changes.

“People do need to plan. If they’re going to lose coverage, they need to figure out how to get it,” Yarmuth said. “And insurers in Kentucky would have to figure out how it would affect them if the waiver is approved. Because the people then would be in the market if they lost their coverage.”

Bevin’s spokesperson said in an email that the state is still in negotiations and is feeling optimistic.

The governor’s office estimated the approval of the waiver would result in 17,000 Kentuckians no longer on Medicaid after one year and a total of 85,000 people five years. The Governor’s office said that’s mainly because of employment and private market enrollment increases.

Lisa Gillespie is WFPL's Health and Innovation Reporter.