KY Policy Blog

Waiver Proposal Says Cost Savings Come from Covering Fewer People

By Jason Bailey
June 23, 2016

The Medicaid waiver proposal the administration has drafted claims the changes will save $2.2 billion over the first 5 years of the program. But the data shows those savings would occur because fewer Kentuckians are covered — the exact problem of lack of coverage Kentucky’s Medicaid expansion has been so successful at addressing.

The data provided shows 17,833 fewer people will be covered by Medicaid in the first year of the demonstration compared to not having the waiver, a number that would grow to 85,917 in year 5 (data from read more

What’s In the Governor’s Proposed Medicaid Changes

By Jason Bailey
June 22, 2016

Governor Bevin rolled out proposed changes to Kentucky’s Medicaid program that would put up harsh new barriers to coverage and care for Kentuckians including premiums and work requirements. The plan also reduces benefits and creates complex new administrative systems to track and collect payments and activities.

The proposal, called a Section 1115 waiver to the Medicaid program, is subject to public comments in Kentucky before going to the Department of Health and Human Services (HHS) for their consideration and response. Aspects of the proposal put Kentucky’s nation-leading health gains at read more

What Are Medicaid Waivers?

By Dustin Pugel
May 20, 2016

Kentucky has had great success in reducing the number of people who are uninsured since it expanded Medicaid coverage through the Affordable Care Act. Since that time, Governor Bevin has announced he will seek changes to the program through a federal waiver process.  But the word waiver has more than one meaning when it comes to Medicaid, and can mean both positive changes to the program as well as changes that create new barriers to the coverage and care Kentuckians need.

The federal government offers two ways a state can read more

Governor Vetoes Need-Based Scholarships for Thousands of Students

By Jason Bailey
April 28, 2016

Governor Bevin vetoed $40.3 million in funding for need-based college scholarships contained in House Bill 10, meaning denied aid for nearly 22,000 low-income students that had been awarded by the General Assembly. This is at the same time the budget cuts funding for higher education by 4.5 percent, leading to tuition hikes at the public universities and community colleges.

The governor’s vetoes also delay the start of the Work Ready Scholarship, a program designed to help some traditional-age students pursue associate’s degrees, by one year from 2017 to 2018. That read more

Indiana Medicaid Waiver Model Should Not Be Replicated in Kentucky Without Evaluation

By Ashley Spalding
April 15, 2016

With Kentucky considering pursuing a waiver that makes changes to its Medicaid program — and looking at Indiana’s waiver design in particular — it is important to keep in mind how much we still don’t know about the model’s implementation and effectiveness.

As shown in a new paper by the Center on Budget and Policy Priorities (CBPP), there are serious questions about the data coming out of Indiana. As CBPP argues, it’s unwise to replicate the ideas Indiana has piloted before they are thoroughly evaluated.

Indiana is one of six read more

Uninsured Costs at U of L Hospital Have Dropped Dramatically Because of Medicaid Expansion and Kynect, But Could Go Up with Changes

By Jason Bailey
March 22, 2016

Senate leaders have raised a concern about the House’s inclusion of up to $10.5 million in their budget over the biennium to help cover health care costs for the uninsured at University of Louisville Hospital. They argue that if the Affordable Care Act (ACA) was working so well, that appropriation wouldn’t be needed.

But a look at the data shows costs for the uninsured at the hospital have dropped dramatically since Kentucky created Kynect and expanded Medicaid, saving tens of millions of dollars for the state, the city of Louisville read more

House Should Vote to Keep Kynect and Protect Medicaid Expansion from Harmful Changes

By Jason Bailey
March 20, 2016

The House has the opportunity this week to pass House bills 5 and 6 and vote to maintain Kentucky’s momentum for better health and a stronger economy.

House Bill 5 would keep Kynect, the state’s nationally-recognized system for getting people the health coverage they are eligible to receive, a program that has led to the best coverage gains in the country. House Bill 6 would protect Medicaid expansion from harmful changes, like those being pursued in Indiana, that threaten to reduce access to coverage and care for many.

Here are read more

House Budget Does Not Restore Many Crucial Services for Vulnerable Kentuckians

By Anna Baumann
March 18, 2016

The House budget bill builds on Governor Bevin’s proposed funding for KTRS and KERS and rightly restores his cuts to P-12 and higher education. However, it maintains reductions to other budget areas, including parts of the Cabinet for Health and Family Services (CHFS) that serve Kentucky’s most vulnerable citizens.

The House budget appropriates a total of $2.5 billion in 2017 and $2.7 billion in 2018 from the General Fund (GF) to the Cabinet – just over $12 million (or 0.5 percent) more each year than the Governor proposed. $10.6 million read more

It’s Kentucky’s Lack of Coverage and Poor Health that Are Unsustainable, Not Medicaid

By Jason Bailey
March 10, 2016

While the administration claims that Kentucky’s Medicaid program is “unsustainable,” in fact Medicaid is a big benefit to Kentucky as it fills critical coverage gaps, improves health, injects dollars into communities and saves money in the budget previously spent on the uninsured.

Medicaid Is Helping Kentucky Cope with Economic Changes Medicaid costs aren’t up because of any flaw in the program, but because of the impact of more people qualifying for Medicaid in a challenging economy.

The bottom fell out in the Great Recession, with 119,000 Kentuckians losing their jobs. read more

With Medicaid Expansion, Kentucky Healthcare Job Growth Picked Up in 2015

By Jason Bailey
March 9, 2016

After modest growth in health care and social assistance jobs during the first year of Medicaid expansion, growth picked up at a rapid pace in 2015, according to newly-revised Bureau of Labor Statistics data. The billions of additional federal dollars coming in to the state to provide care for the newly insured likely played a role.

As shown in the graph below, jobs in the sector were tapering off before the state began signing people up for Medicaid expansion. Hospital employment declined (in Kentucky and nationally) as that industry reorganized read more