Last Call For The Same Old Bevin

Joe Sonka details the "changes" that Kentucky GOP Gov. Matt Bevin has made to his planned waiver of Medicaid expansion, which the federal government basically told him that he wasn't going to get approved.  Bevin apparently doesn't give a damn and is submitting it anyway, and is daring the Department of Health and Human Services to tell him to piss off so he can blame somebody else when Kentucky Republicans take health coverage away from ten percent of the state.

Under the waiver proposal dubbed Kentucky HEALTH and first unveiled in June, individuals with income up to 138 percent of the federal poverty rate would still be eligible for expanded Medicaid, though “able-bodied” persons would have to pay a monthly premium to maintain coverage and could be locked out from coverage if payments are missed. Such individuals also would no longer be automatically eligible for benefits such as vision and dental, having to earn credits in their My Rewards Account by having health risk assessments, volunteering, taking smoking cessation classes, having a job or being in school. 

Bevin reiterated in a press release announcing the submission of the 87-page waiver on Wednesday that his plan would lead to better health outcomes, ensure the long-term sustainability of the state’s Medicaid program — as Kentucky must begin to kick in a small percentage of costs for covering the expanded population next year — and “familiarize members with commercial insurance and prepare them for self-sufficiency.” 

“The submission of this waiver is the result of many months of extensive research, planning and time spent traveling the state listening to Kentuckians,” said Bevin in his press release. “Kentucky HEALTH will allow us to continue to provide expanded Medicaid coverage, but unlike the current Medicaid expansion under Obamacare, it will do so in a fiscally responsible manner that ensures better health outcomes for recipients.”

The major scam here is the "My Rewards Account", like any health savings account you put money into to cover your medical expenses, but you lose all the money in it at the end of the year.  It's a tax on people who are bad at predicting exactly how sick they'll get in the course of 12 months, underestimate it and you lose your coverage for non-payment of premiums, overestimate it and you pay the state extra tax money you really can't afford.  It's a fun guessing game, and the winner is Bevin, every time.

While Bevin’s proposal had received wide praise from Republican officials in Kentucky, health care advocacy groups have expressed concern that requiring premiums and locking people out of coverage for failure to make payments would serve as an obstacle to many low-income individuals and families gaining Medicaid insurance. HHS also has emphasized that states seeking a waiver to alter its Medicaid expansion may not limit access to coverage or benefits by conditioning eligibility on work or other activities, impose premiums or cost sharing at levels preventing low-income individuals from accessing coverage, or penalize people for needing Medicaid coverage for multiple years. 

When unveiling his proposal in June, Bevin warned that if HHS does not approve the waiver, then “there will not be expanded Medicaid in the state of Kentucky,” an indication that he would either repeal the executive order of former Gov. Beshear to expand Medicaid — which resulted in over 400,000 people receiving coverage — or decline to reauthorize it next year. When asked what he would do if HHS only approved of 90 percent of Kentucky’s waiver proposal, Bevin said at the time that there is still a “negotiating process” going forward. 

HHS press secretary Marjorie Connolly released the following statement after Gov. Bevin’s announcement, again praising the success of Kentucky’s Medicaid expansion over the past few years and indicating that the process going forward could still take considerable time. 

“Kentucky’s Medicaid expansion has been very successful in improving health coverage, access to care, health outcomes, and financial security for its citizens,” said Connolly. “HHS has been clear that, as we begin the review of this application, we will assess it based on longstanding Medicaid principles of access to coverage and affordability of care. As in other states, we are prepared to continue dialogue for as long as it takes to find a solution that maintains and builds on Kentucky’s historic progress, and avoids moving backwards.”

Except backwards is exactly where Bevin is heading with this.  He's holding health insurance coverage for 400,000 plus Kentuckians hostage, and either he gets what he wants or the people of the Bluegrass State get it right between the eyes.

That's our governor!