KY Policy Blog

Four New Ways Kentuckians Will Lose Medicaid

By Dustin Pugel
January 30, 2018

Low-income and disabled Kentuckians are currently eligible for a broad range of health care benefits thanks to Medicaid. As long as people earn below a certain annual wage (a little over $16,700 for adult individuals), or have certain disability-related needs, they qualify. But Kentucky’s recently approved changes to our Medicaid program (known as an 1115 waiver) removes benefits like dental and vision coverage and adds four new ways for people to lose coverage. The documentation attached to the waiver request estimates these new barriers will be the primary reason that read more

Medicaid Work Requirement Is Misguided and Harmful

By Dustin Pugel
January 11, 2018

With the recent guidance by the Centers for Medicaid and Medicare and Medicaid Services (CMS) on work requirements, it is very likely that Kentucky’s request to implement a “community engagement” condition of Medicaid eligibility will be approved. Work requirements for public benefits are harmful, and don’t achieve their supposed goals of reducing poverty, promoting long-term economic advancement and making people healthier. Cutting off peoples’ ability to get to a doctor when they need to only makes it harder for them to keep working, or find meaningful employment. Rather than punishing read more

Marketplace Signups Robust and Would Likely Be Stronger Without Barriers

By Dustin Pugel
January 8, 2018

Early in 2017, the Department for Health and Human Services (HHS) cut the Healthcare.gov open enrollment period in half, from 14 to 7 weeks. Despite this and other impediments described below holding back enrollment, 9,000 more Kentuckians signed up for health insurance than last year, a 12 percent increase, outpacing all other healthcare.gov states. Across the board, demand for affordable coverage through Healthcare.gov was strong this year, ending at similar levels of enrollment to last year.

Automatic renewal may have helped enrollment numbers, but ending Kynect was setback

While the read more

Medicaid Works for Kentucky

By Dustin Pugel
October 3, 2017

Medicaid provides health care coverage to over 1.4 million Kentuckians. For over 50 years it has helped pregnant women, children, people with disabilities and seniors and in the past 3 years it has allowed all low-income Kentuckians under 138 percent of poverty to get care when they need it. This critical health program has been at risk in 2017 for severe cuts under healthcare repeal efforts in Congress, and will face continued threats for more cuts through the federal budget process and the changes to Kentucky’s Medicaid program proposed to read more

Cassidy-Graham Bill is Latest Attempt to Unravel Kentucky’s Health Care Gains

By Dustin Pugel
September 15, 2017

The latest attempt to repeal the Affordable Care Act (ACA), known as the Cassidy-Graham bill, would cut Kentucky’s funding for low-income health care by $3.1 billion by 2026. That would be the 8th largest cut in the country, even though Kentucky ranks only 26th in the size of its population.

The bill would undermine health care coverage for millions of Americans in three main ways.

A block grant that squeezes funding for 10 years and then runs out

Perhaps the most devastating of the bill’s cuts would result from turning read more

Ending Cost Sharing Reduction Payments is a Lose-Lose for Kentucky

By Dustin Pugel
August 15, 2017

Since 2014, the federal financial assistance for out-of-pocket health care costs known as Cost Sharing Reductions (CSRs) has been under threat – first from a lawsuit filed by the House of Representatives, and now by threats from President Donald Trump to stop paying for it. In either case, ending those payments would hurt middle-class families who purchase insurance through the exchanges, destabilize the insurance market and raise costs for the federal government.

What are CSRs and how do they work?

CSRs help low-income people use the insurance they purchase on read more

Kentuckians Are Concerned About Proposed Changes to Medicaid

By Dustin Pugel
August 9, 2017

Kentucky officials recently asked the Centers for Medicare and Medicaid Services (CMS) to change certain parts of their original request to alter the commonwealth’s Medicaid program. These changes would move Kentucky’s health and economy further in the wrong direction by making the work requirement more difficult to comply with and instituting a six-month lock out for enrollees who fail to report relevant changes in income or employment hours within ten days.

State officials decided to open a comment period for public input on these changes. The result was that 1,273 read more

How Cuts to Federal Non-Defense Discretionary Funding Would Impact Kentucky

By Ashley Spalding
August 8, 2017

When Congress returns from its August break, the House is expected to vote on their plan for 2018 appropriations that includes cuts to non-defense discretionary (NDD) funding, as well as deep cuts to entitlement programs. The proposed cuts to NDD programs would harm our state’s ability to improve education, support children and families, make our communities safer and healthier and develop the workforce and economy.

As noted previously, the proposed House appropriations for NDD programs would be 17 percent below what was appropriated in 2010 after adjusting for inflation and read more

Revised Senate Health Repeal Has Same Harmful Impacts

By Jason Bailey
July 13, 2017

Senate leaders released a “new” version of their bill to replace the Affordable Care Act that fixes none of the original Senate bill’s core problems and makes some of them even worse.

Through its cuts in funding, the Senate bill would effectively end Kentucky’s highly-successful Medicaid expansion, resulting in lost coverage for 473,000 Kentuckians. The bill goes beyond that to permanently harm the traditional Medicaid program by instituting caps that will squeeze funding over time. Those caps will jeopardize coverage for another nearly 1 million Kentuckians, including people with disabilities, read more

Kentucky Has the Most to Lose from Senate Health Care Repeal Bill

By Dustin Pugel
June 28, 2017

Kentucky would see its uninsured rate more than triple under the proposed Senate bill to repeal the Affordable Care Act (ACA). According to the Urban Institute, Kentucky’s uninsured population would jump by 541,000 people in 2022 based on the proposed changes to the healthcare system. The primary reason for the coverage losses is a cut in federal funding for Medicaid and premium subsidies on the insurance marketplace of $6.3 billion in 2022, a  58.5 percent reduction. That’s the largest percentage cut of any state.

The coverage losses under the Senate read more