Kentucky scores first Medicaid work requirement approval
Kentucky is done. Who’s next?
The Bluegrass State became the first to receive federal approval to impose work requirements as a condition of having Medicaid coverage.
“Your substantial work will help inform future state demonstrations seeking to draw on Kentucky’s novel approaches to Medicaid reform,” Brian Neale, CMS’ Medicaid director, said in the letter to Republican Gov. Matt Bevin.
Bevin originally submitted the waiver request in August 2016.
Nine other states—Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah and Wisconsin—have also applied for similar Section 1115 waivers.
In the coming weeks, adult beneficiaries in Kentucky between 19 to 64 will be required to complete 80 hours per month of community engagement activities—including employment, education, job skills training and community service—to maintain their Medicaid eligibility.
Former foster-care youth, pregnant women, primary caregivers of a dependent, beneficiaries considered medically frail and full-time students are exempt from the new requirements.
The CMS also approved Kentucky’s request to impose premiums on Medicaid expansion beneficiaries and parents and other family caretakers in the state. Nonpayment over a 60-day period will result in a six-month lockout from coverage. Enrollees will also lose coverage if they don’t report income changes quickly.
The new waiver nixes providers’ ability to bill for services provided in the three months before the application, assuming the patient was eligible during that time.
“New barriers to getting covered and new ways of getting kicked off coverage will hurt working Kentuckians, healthcare providers and our economy,” said Dustin Pugel with the Kentucky Center for Economic Policy, a left-leaning think tank, in a statement. Pugel estimated that as many as 100,000 Medicaid enrollees will lose coverage as a result of the waiver.