Ky. governor who opposed Medicaid expansion offers plan with premiums, work-oriented rules

Gov. Matt Bevin (Courier-Journal photo by Michael Clevenger)

The new Republican governor of Kentucky, who as a candidate said he would abolish the Medicaid expansion of his Democratic predecessor, unveiled his plan for big changes that would preserve the expansion -- if Obama administration officials approve.

Most Medicaid members "would have to pay premiums of $1 to $15 a month, and be more actively involved in their health care," Al Cross and Melissa Patrick report for Kentucky Health News. "The program would no longer include some benefits, such as dental and vision care. However, recipients could gain access to those benefits, as well as non-prescription drugs and gym-membership subsidies, by enrolling in job training, volunteer work or health-related classes."

"There is nothing good or healthy or productive, long-term for the individual or for society as a whole, that comes from able-bodied, working-age men and women with no expectation of their involvement and no opportunity for that involvement," Gov. Matt Bevin said. "So we are providing an expectation and an opportunity and a reward. . . . When they get out there and they get engaged and they start to realize the value that they add, it will change people's lives."

The plan also asks for Medicaid funding of inpatient substance-abuse treatment, something Bevin said no other state has done, in an effort to address the state's growing drug-abuse problems. This would be a demonstration project limited to 10 to 20 "high risk" counties that have not been chosen.

The plan says it "represents the terms under which the Commonwealth will continue Medicaid expansion," and Bevin said that if federal officials don't approve it, he would end the expansion, which provides largely free health care for about 400,000 Kentuckians. But he said he was confident that federal officials would approve the request, which seeks a waiver of a wide range of Medicaid rules, because he and his aides have been in frequent contact with the Center for Medicare and Medicaid Services and its overseer, Health and Human Services Secretary Sylvia Burwell.

The plan must undergo a 30-day comment period with public hearings, after which it will be finalized and submitted to CMS. (Read more)