While Gov. Matt Bevin’s administration is privately working on a plan to change Kentucky’s expanded Medicaid system, a coalition of advocacy group has created its own recommendations.

Bevin has said his administration would apply for a federal 1115 waiver — a course of action that allows states to test out new ways to operate Medicaid.

Although there hasn’t been any public input on the waiver process, a coalition called Kentucky Voices for Health has crafted its own suggestions designed to improve health and manage costs of the system.

Rich Seckel, executive director of Kentucky Equal Justice Center, said the group’s report could help improve the Medicaid system.

“What I found exciting about these recommendations was not the sort of predictable concern about cost barriers but the opportunity to do some innovation,” Seckel said.

Bevin has revealed few details about how he wants to change the program, though during last year’s gubernatorial campaign, he suggested scaling back eligibility and requiring beneficiaries to pay monthly premiums.

Kentucky’s Medicaid commissioner said the plan would not require beneficiaries to pay premiums but still might reduce benefits, according to an Associated Press report.

In one of their recommendations, Kentucky Voices For Health suggests the state “maintain the current range and level of benefits for all Medicaid recipients” and not add premiums or additional co-pays.

More than 400,000 people got health insurance through the current Medicaid expansion, created by Gov. Steve Beshear under the Affordable Care Act. The expansion made Kentuckians who earn up to 138 percent of the federal poverty line eligible for coverage.

The task force also recommends establishing a “community innovation fund” that would allow health care providers to collaborate with community-based partners. And they suggest increasing the reimbursement rates for providers and further developing Benefind to help manage care and measure results.

Beshear has criticized Bevin for working on the Medicaid waiver without gathering public input. Seckel said stakeholders should be brought in to the conversation.

“It’s less clear both in the planning process and in what may be down the road sort of how that process of continuous input is going to occur,” he said.

The Affordable Care Act includes provisions requiring states to hold public hearings before submitting a formal 1115 waiver request, which Kentucky hasn’t done yet. Once the application is in, the federal government will hold a public comment period and put the application on Medicaid.gov for at least 30 days.

Ryland Barton is the Managing Editor for Collaboratives.