Protecting Medicaid’s Role in Advancing a Healthy Kentucky

By Mary Cobb
May 16, 2016

To view this report in PDF form, click here.

A new report by the Kentucky Center for Economic Policy provides an in-depth look at Medicaid in Kentucky, the benefits of Medicaid expansion and potential harmful impacts of changes that could create barriers to coverage and care.

The report was prepared in expectation of a proposal from Gov. Bevin to apply for a Medicaid waiver that might involve additional costs to recipients, benefit changes or other provisions.

The report highlights several key facts and points, including:

  • Medicaid is key to the health of Kentuckians for its role in covering many children, working adults, veterans, senior adults and the disabled. With Medicaid expansion, the program’s positive benefits are growing including a significant increase in health screenings, budgetary savings and a recent uptick in job growth in the health care sector.
  • The benefit package offered in Kentucky’s Medicaid program is reasonable and very similar to other states: most all of the services covered in Kentucky are also covered in least 40 other states or territories. And many other states offer important benefits not currently offered in Kentucky.
  • Some waiver ideas put forward by other states have the potential of impeding access to needed care, including premiums, lockout periods and elimination of certain benefits. Certain ideas introduce new administrative expenses that could end up costing the state more than any new revenue or savings generated. Also, there is a long list of state waiver requests the federal government has consistently rejected including: high premiums, benefit-reduction requests, work requirements and partial expansions.

Kentucky is in a unique situation among states because it has already expanded Medicaid while other states used a waiver-based approach in the decision to expand. By law, Kentucky cannot make changes designed simply to save money relative to the current program. Changes must meet the law’s goals of increasing coverage, expanding the provider network, improving health outcomes and/or improving the efficiency and quality of care.

The report concludes with recommendations that include active public participation in the process of developing a proposal, transparency, independent assessment of any changes and a focus on long-term benefits to the health of Kentuckians.