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Disruption to Medicaid benefits sparks outcry across Kentucky

Critics of the Bevin administration are crying foul after a decision by the state to disrupt dental and vision benefits that certain Medicaid recipients would have received as part of the state’s now-halted Kentucky HEALTH program.

Soon after a judge ruled against the Bevin administration’s planned overhaul of Medicaid, the state Cabinet for Health and Family Services posted a notice online June 29 saying that people who would have had access to vision and dental services through a portion of the program called My Rewards would no longer have access to that account.

Responding to questions from Insider Louisville earlier this week, the Cabinet said via email: “When Kentucky HEALTH was struck down by the court, the ‘My Rewards Account’ program was invalidated, meaning there is no longer a legal mechanism in place to pay for dental and vision coverage for about 460,000 beneficiaries who have been placed in the Alternative Benefit Plan. As such, they no longer have dental and vision coverage as a result of the court’s ruling.”

“The Cabinet for Health and Family Services made it clear that dental and vision benefits were dependent on the implementation of the Kentucky HEALTH waiver and that without the waiver, immediate benefit reductions would be required to compensate for the increasing costs of expanded Medicaid,” the email stated.

Gov. Matt Bevin had previously filed an executive order directing his administration to end Medicaid expansion in Kentucky if any part of the Medicaid waiver was blocked by a legal challenge in the court system.

Cabinet Secretary Adam Meier also has said recently that without Kentucky HEALTH, the state wouldn’t be able to afford to cover the expanded Medicaid population and would probably have to remove dental and vision coverage for them.

Over the weekend, a consumer advocacy group, Kentucky Voices for Health, issued a statement, expressing concern, and a group of Democratic leaders, including state Rep. Joni Jenkins (D-Shively) and Congressman John Yarmuth, are holding a news conference in Louisville Monday morning.

“We are concerned about rash decisions made in response to the court ruling,” Jenkins said in a news release. “We call for thoughtful discussions involving the administration and the many statewide stakeholders in the path forward in assuring Kentucky’s working families have healthcare.”

Much of the Kentucky HEALTH program, also known as the state’s 1115 Medicaid waiver, had been scheduled to go into effect July 1, but a judge ruled last Friday afternoon (June 29) that significant omissions had been made in the program’s federal approval and that further review by the U.S. Department of Health and Human Services is warranted. The ruling came in a lawsuit that had been filed by more than a dozen Medicaid recipients claiming that the waiver approval was illegal and would result in many people losing their benefits.

The Kentucky HEALTH program called for certain Medicaid recipients to have to complete community engagement requirements, such as working, volunteering or getting job training, to keep their benefits. Its My Rewards feature allowed recipients to earn virtual dollars by taking steps, such as taking classes and getting preventive services, to pay for vision and dental services.

But a statement from the state Cabinet for Health and Family Services advised: “As of July 1st, your medical benefits will continue as they are today with no change. However, if you received a notice saying you could access vision and dental services through a My Rewards Account, you will not have access to dental and vision benefits. The legal decision has stopped the ability to use the My Rewards dollars in order to purchase dental and vision services.”

In a statement, Kentucky Voices for Health — which had been a vocal opponent of Kentucky HEALTH — says the move by the Bevin administration “goes against federal Medicaid rules that a State Planned amendment first be approved by CMS to reduce benefits, followed by filing a revised state regulation, holding a public comment period, and providing notice to affected Medicaid members.”

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