Sylvia Burwell, U.S. secretary of health and human services, raised concerns about Bevin's plans for Medicaid expansion, citing the "historic improvements" in health coverage for Kentuckians. She also questioned Bevin's plans for dismantling kynect, the state health insurance exchange where people may shop for private plans or enroll in Medicaid.
Burwell addressed the proposed changes in two separate letters last week – one to Bevin and one to [KY Attoney General Andy] Beshear.
In a July 20 letter to Bevin, Burwell described his plans to dismantle kynect as "highly aggressive" and said it is uncertain whether "we can confirm a transition will be possible this year."
As for Bevin's plan to restructure the Medicaid expansion, Burwell, in a separate letter to Beshear, said her agency will review Bevin's request in light of federal law directing that any changes strengthen coverage and increase access to health care.
"As you know, Kentucky's Medicaid expansion has led to one of the biggest reductions of uninsured people in America," said Burwell, responding to a May 9 letter from Beshear questioning Bevin's plans for Medicaid. "We are committed to the principle that any changes to the program maintain or build on the historic improvements Kentucky has seen in access to coverage, access to care and financial security, rather than take the state backward."
The Bevin administration said it expects to meet all federal deadlines for dismantling kynect and said Kentuckians should plan to use the federal website to shop for health coverage this fall.
It disputed Burwell's characterization of the Medicaid expansion.
"There has not been a historic drop in uninsured – this is misleading," West's statement said. "Medicaid is not health insurance – it is a benefit program like SNAP (food stamps) or TANF (Temporary Assistance for Needy Families) ... What we have seen is a historic rise in people on taxpayer-funded Medicaid."
In other words, Bevin is trying to sell the state's Medicaid expansion not a health insurance, but welfare or food stamps: something that only those people use and people like us pay for.
I'm glad to see Secretary Burwell isn't having any of it, especially bringing up the very real possibility that HHS will call Kentucky out and say that Bevin's plan to destroy kynect and have everything ready by October isn't realistic, considering October is only two months and change away.
But for Bevin's team to sell the Medicaid expansion as not helping to insure Kentuckians, rather to view it as awful icky welfare, is absolutely incorrigible.
I hope Burwell calls his bluff.