Senior Policy Analyst
The Department of Health and Human Services (HHS) has approved a waiver that will let Kentucky make harmful changes to its Medicaid program for adults, including imposing a work requirement, as we explain in a new paper. The state doesn’t need a waiver to help low-income Kentuckians improve their health and well-being; it’s already made dramatic progress toward these goals since it expanded Medicaid under the Affordable Care Act (ACA) in 2014.
HHS’ approval letter says that Kentucky’s waiver “has been designed to empower individuals to improve their health and well-being.” But imposing a work requirement, instituting premiums, increasing cost-sharing, and disenrolling beneficiaries for not renewing eligibility or reporting changes in income — as the waiver will do — will likely create a maze of new red tape for beneficiaries, providers, and managed care organizations that will cause large numbers of Kentuckians to lose coverage or have a harder time getting the health care they need.
The waiver puts at risk the remarkable success of Kentucky’s Medicaid expansion (see graphic):
Governor Matt Bevin’s administration has conceded that, under the waiver, 100,000 fewer Kentuckians will have Medicaid coverage in five years than if there were no waiver. This ensures that the state’s record-low uninsurance rate will creep back up. With this waiver, Gov. Bevin and the Trump Administration have put low-income Kentuckians’ coverage and access to care at risk in the coming years.