FRANKFORT (AP) — The more than 400,000 people who received health insurance from Kentucky’s expanded Medicaid program will likely not have to pay monthly premiums under Republican Gov. Matt Bevin’s reforms, but they could have reduced benefits, the state’s Medicaid commissioner said Friday.
Kentucky Medicaid Commissioner Stephen Miller, appointed by Bevin in February, told The Associated Press the Bevin administration does not plan to include monthly premiums as part of its application to the federal government to overhaul the state’s Medicaid program.
Bevin has previously said he supports the idea of Medicaid recipients having “skin in the game” by paying monthly premiums for their coverage.
But Miller said negotiations with officials at the Centers for Medicare and Medicaid Services, a division of the U.S. Department of Health and Human Services, indicate they will not approve a plan that requires Kentucky’s expanded Medicaid population to pay for a portion of their health insurance.
“That, today, is not part of the plan,” Miller said. “That is something that’s going to be a tough sell.”
The governor’s office indicated Friday that Miller’s comments were preliminary.
“Everything is on the table and no decisions have been finalized,” said spokeswoman Jessica Ditto.
Miller said some Medicaid recipients could see fewer benefits under the new plan. Right now, he said the health insurance plan for the state’s Medicaid recipients is better than the basic plan offered to state employees. He said the new plan will likely bring the Medicaid plan more in line with the health plan offered to state workers.
“That would be a reduction in some benefit levels, such as in vision, dental,” Miller said, adding the plan would be designed to use Medicaid as a way to transition people to the private health insurance market. “We’re trying to help move that along so it’s not looked at as a lifetime entitlement.”
Miller also said the plan could include a reward system. He described a health savings account that would be funded based on people’s “healthy practices,” including participating in smoking cessation and weight-loss programs.
“If we can get people to be healthier and follow healthier habits, it may sound like we are rewarding them for that but the long-term effect is it makes their health care coverage less expensive,” Miller said.
The new program must be signed off by Bevin and then approved by the federal government. Miller said officials hope to release the plan publicly by the end of next month, followed by a public comment period.
Kentucky was one of 32 states that opted to expand its Medicaid program under the federal Affordable Care Act. More than 400,000 people signed up for the expanded service in Kentucky, helping reduce the state’s uninsured population to 7.5 percent from 20 percent in just two years.
But the influx of new people increased the state’s costs. Over the next two years, Kentucky taxpayers will pay $257 million for those people to have health insurance — much more than state officials had anticipated. As a result, Bevin announced he would repeal Kentucky’s Medicaid expansion and replace it with a new program.
Miller said the state plans to submit the proposal to the federal government in September and hopes to have a resolution by November.
Ben Wakana, a spokesman for the U.S. Department of Health and Human Services, said any changes to Kentucky’s program “should maintain or build on the historic improvements Kentucky has seen in access to coverage, access to care, and financial security.”