Health

The Trump administration has again approved work requirements or a suitable alternative for Kentucky’s Medicaid population after a judge blocked the state’s first attempt earlier this year.

The Kentucky Cabinet for Health and Family Services said Tuesday the new rules can begin as soon as April 1 and will be phased in regionally over several months. They will require some adults to complete 80 hours of “community engagement” each month, which includes a job, volunteering or going to school.

“Kentucky HEALTH offers a customized path based on individual needs that will help beneficiaries gain better health, engagement in their communities, improved employability, and success through long-term independence,” said Cabinet Secretary Adam Meier.

A federal judge blocked the program in June. The ruling re-started the application process, which was completed Tuesday.

Across the country, people in rural areas and small towns registered the largest gains in health insurance because of the Affordable Care Act. That was true in Kentucky, too. In 2009, 40 percent of low-income adults living in the state’s rural areas and small towns didn’t have health insurance. By 2016, that number had dropped to 13 percent.

Kentucky Gov. Matt Bevin has estimated the Medicaid changes would shave about 95,000 people off the state’s rolls.

Arkansas was the first state to implement work requirements for Medicaid. Last week, the state announced more than 12,000 people had lost coverage in the past three months.

InsureKY, a statewide coalition of nonprofits, issued a statement expressing disappointment with the move.

“Kentucky Voices for Health and our partners are deeply disappointed that CMS and, by extension, the state, have once again ignored the voices of their constituents,” said Emily Beauregard, Executive Director for Kentucky Voices for Health. “During the 2018 federal comment period, thousands of Kentuckians spoke up to share why access to healthcare is critical to their ability to be good parents and caregivers, productive employees, successful entrepreneurs, and contributing members of their communities. Reapproving a waiver that makes hardworking Kentuckians jump through hoops to keep their coverage will no doubt have the opposite effect.”

Who’s Affected?

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 the new requirements 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 Waivers.

This story has been updated.

Lisa Gillespie is WFPL's Health and Innovation Reporter.