Kentucky officials on Monday heard from the public on proposed state regulations that would go into effect if the federal government approves controversial Medicaid changes, also known as Kentucky HEALTH.
Those changes were blocked in June when a federal judge struck down the Trump administration’s approval of the Medicaid overhaul, after an advocacy group filed suit against the federal government. In July, the federal government re-filed the Medicaid waiver and opened a new comment period for those changes. That comment period just ended, and it’s likely changes will be re-approved at some point in the future.
Kentucky’s proposed regulations provide technical details for how the program would be rolled out. The regulations signal that the state is preparing for a re-approval. Department of Health and Human Services Secretary Alex Azar told the New York Times earlier this month that the department remains undeterred.
“We suffered one blow in a district court in litigation,” Azar said. “We are proceeding forward. We are fully committed to work requirements and community participation requirements in the Medicaid program. We will continue to litigate. We will continue to approve plans.”
Cabinet for Health and Family Services spokesman Doug Hogan wrote in an email that the state is optimistic that the federal government will re-approve the Medicaid changes.
“It’s imperative that Kentucky HEALTH be re-approved in order to create better health, wellness, education and employment outcomes for our recipients and create sustainability for the Medicaid program,” Hogan wrote.
Adrienne Bush, executive director of the Homeless and Housing Coalition of Kentucky, attended Monday’s public hearing on the proposed regulations. Bush said her organization assumes the state will gain re-approval and wants to help recipients through the process.
“So our perspective at this point, we want to make sure that the most vulnerable people know what is going on — that we’re communicating that — and know what’s required of them,” Bush said.
Bush’s concern for people who are homeless and have Medicaid is that although they would be able to apply for a “medically frail” exemption, that process could take time. Without that designation, a person would have to pay co-pays and might be locked out of coverage for not doing so. They would also have to work, volunteer or do community service for 80 hours a month to keep coverage, and report that work online.
“We are very concerned that if somebody missteps or misses a reporting deadline, or doesn’t have access to the portals that the Cabinet has set up, that they are going to be locked out of coverage,” Bush said.
Judy Solomon, senior fellow at the left-leaning Center on Budget and Policy Priorities, said Kentucky’s proposed regulations that lay out the technical details of the waiver are a sign that the state wants to be prepared to implement as soon as the feds give the green light.
“They’re getting ready,” Solomon said. “Some of these regulations can’t go into effect unless they have permission to do so, like the work requirement. Given [that] the regulation process takes time, I’m assuming that they’re getting ready.”
Although the federal comment period has ended, the state comment period remains open until August 31. You can read the proposed regulations here.