KY Policy Blog

Number of Uninsured Kentuckians Would Triple Under a Partial Health Reform Repeal

By Dustin Pugel
December 8, 2016

An estimated 486,000 Kentuckians would lose insurance coverage under a partial repeal of the Affordable Care Act (ACA), a tripling of the number of uninsured in the state, according to a new report from the Urban Institute. This decline would come from people losing Medicaid coverage, federal insurance marketplace (formerly Kynect) subsidies, the individual mandate and the individual insurance policy market.

The losses of coverage in Kentucky would be the third highest of any state.

aca-repeal

The congressional plan to repeal the ACA, while delaying full implementation for two years, would read more

Comments to Washington on Proposed Medicaid Changes were 9 to 1 Against

By Dustin Pugel
October 12, 2016

The period to give input to the Cabinet for Health and Human Services (HHS) on Governor Bevin’s proposed changes to Medicaid ended last Saturday with a total of 1,749 responses. The responses were overwhelmingly in opposition to the changes the governor proposed and in support of the program as it currently exists, as shown in the graph below:

waiver-comments-pie-chart

Source: KCEP Analysis 1 of Comments made to HHS on Kentucky’s 1115 Waiver Request (https://public.medicaid.gov/connect.ti/public.comments/questionnaireResults?qid=1888067)

After removing identical responses submitted from the same commenter, responses that weren’t related to the waiver request read more

A County-by-County Look at Potential Enrollment Decreases from Proposed Medicaid Waiver

By Dustin Pugel
September 1, 2016

The Governor is seeking to make changes to Kentucky’s Medicaid program in a way that would result in 87,639 fewer traditional and expanded Medicaid enrollees by 2021, according to official projections. This represents a total drop in enrollment of 6.6 percent from the starting point of October 2015. What does that mean across Kentucky counties?

The map below shows how many people would likely lose coverage in each Kentucky county if the enrollment drops were proportional to the traditional and expansion Medicaid population in counties. Enrollment drops are steepest in read more

Modest Savings from Medicaid Waiver Ignore Added Costs and Mostly Don’t Come from Expansion Population

By Dustin Pugel
August 31, 2016

The Bevin administration has submitted the revised version of its request to make changes to Kentucky’s Medicaid program and continues to tout the plan’s savings. However, projected state savings are only from covering fewer people, and those savings are small and don’t primarily come from the Medicaid expansion population, which is the portion of Medicaid the administration says we cannot afford. What’s more, savings diminish once the costs of a less-healthy population, the economic losses from fewer federal dollars into the state and higher administrative costs to operate the new read more

New Medicaid Waiver Plan Keeps Approach from Problematic Original Proposal

By Jason Bailey
August 24, 2016

The Bevin administration submitted its waiver proposal to the Department of Health and Human Services (HHS) today, keeping the problematic approach that was in the original plan with modifications in a handful of areas.  The proposal includes work requirements, premiums, lockout periods and other measures that would reduce the number of Kentuckians covered, some of which have been consistently rejected by the federal government in other state proposals.

The revised proposal includes the following measures:

Work Requirements for Participation

The plan includes a requirement that non-disabled adults without children engage read more

A Roundup of Recent Research on Kentucky’s Medicaid Expansion

By Dustin Pugel
August 15, 2016

Kentucky’s Medicaid expansion is building a strong foundation for a healthier state, and this is showing up in the research. When considering changes laid out in the recently proposed Medicaid demonstration waiver, it is important to keep in mind the evidence that backs the state’s current approach.

Kentucky’s current approach to Medicaid expansion is resulting in progress

A new study led by researchers at Harvard’s School of Public Health shows progress on a number of measures in Kentucky and Arkansas, another state that expanded Medicaid, compared to Texas, a state read more

Address Declining Workforce through Job Creation and Work Supports

By Jason Bailey
July 11, 2016

The administration’s proposal to change Medicaid is framed around increasing workforce participation — making it harder for people to get public benefits, it is assumed, will somehow make them more likely to seek work. But as a recent report by the Council of Economic Advisors shows, the gradual decline in the workforce — especially among working age men — can be linked primarily to a loss of decent jobs accessible to less-educated workers as well as the absence of a variety of supports that remove barriers to employment.

Over the read more

Vision Benefits Critical to Health of Kentuckians

By Dustin Pugel
July 5, 2016

An element in the governor’s proposed changes to Medicaid would do away with vision benefits for adults. But the health consequences of eliminating the benefit can be significant. The Centers for Disease Control notes early detection, diagnosis and treatment can prevent significant loss of vision, and “people with vision loss are more likely to report depression, diabetes, hearing impairment, stroke, falls, cognitive decline and premature death.”

In Kentucky there are an estimated 192,060 people who are either blind or have serious difficulty seeing even when wearing glasses, according to 5 read more

Things to Keep in Mind as Public Hearings on Medicaid Proposal Begin Today

By Ashley Spalding
June 28, 2016

The next step in the governor’s 1115 Medicaid waiver proposal is for the state to consider public comments, before submitting the final proposal. With the first of the three public hearings being held today, here are some links to information about the state’s Medicaid program and what the waiver plan would mean for Kentucky:

Medicaid Plays Important Role in the Health of Kentuckians and Benefit Package is Comparable to Other States

Interactive Map Shows Benefits of the Medicaid Expansion Have Been Felt Across the State

Many Who Gained Insurance through read more

Approach to Medicaid Should Reflect Realities Facing Low-Income Kentuckians

By Ashley Spalding
June 24, 2016

Kentucky’s Medicaid waiver proposal frames the issue of health coverage for low-income Kentuckians largely as a problem of Medicaid participants’ lack of understanding about private insurance and failure to engage in work to obtain employer-based coverage. This approach includes several important misconceptions about who is receiving Medicaid, what’s happened to private insurance and how to best promote economic mobility in Kentucky.

Most Non-Disabled Adults With Medicaid Are Already Working

A key component of the 1115 waiver proposal is the addition of work requirements for non-disabled adults without children — making read more