Kentucky Gov. Matt Bevin says he intends to draft a plan to overhaul the state’s expanded Medicaid program by the middle of next year, one that could be implemented by the start of 2017.
Bevin, elected in November, campaigned on a promise to dismantle the state’s Medicaid expansion under the Affordable Care Act.
He said his plan will be fashioned after the one in Indiana, which uses waivers from the federal government that allow states to create their own system for proving coverage to the poor.
He promised his plan will be “transformative,” though provided few details.
“This will not be another version of something you’ve seen,” he said.
Medicaid expansion was the hallmark of former Democratic Gov. Steve Beshear’s administration. It slashed the percentage of uninsured in the state by half, provided health care to 400,000 people and raised the bar to qualify for Medicaid to 138 percent of the poverty line, of $33,000 a year for a family of four.
But Bevin reiterated that he believes the financial toll is unsustainable long-term, particularly with the share of residents on Medicaid now approaching 30 percent. He called the Beshear administration’s predictions that the expansion would pay for itself through job growth in the health industry “happy talk” and “a straight-up, straight-out lie.”
Beshear, who cited a state-funded study in touting the potential job growth, responded with a statement bashing Bevin’s plan as “a vague solution to an unclear problem.”
“All of Kentucky looks forward to the day when our new governor transitions from strident partisan rhetoric and petty name-calling to the real and more difficult business of governing,” he wrote. “Mottos that make good bumper stickers rarely make good public policy. Medicaid expansion was and remains a smart policy move.”
And it remains popular in the state. A recent poll from the Kaiser Family Foundation found that 72 percent of Kentuckians do not want to change the state’s Medicaid program.
At his news conference last week, among his first since taking office, Bevin repeated his campaign pledge that Medicaid recipients need to have “skin in the game.”
The Indiana model, for example, allows the state to charge monthly premiums or require co-pays. Kentucky’s program is mostly free for those who qualify.
Until Bevin’s replacement plan is approved, the current system will remain and the 1.3 million covered by Medicaid in Kentucky should be unaffected.
Bevin announced that Mark Birdwhistell, former secretary of the Cabinet for Health and Family Services, will lead the effort to design a plan and apply for the waivers.
In six months, Bevin said, the administration “will have a very clear understanding of whether this is going to work or not.”
The plan must be approved by the federal Centers for Medicare and Medicaid Services.
Bevin said he is confident that his administration will “find a good and viable solution,” but federal approval is “beyond our control.”