Federal Government Issues Medicaid Waiver Approval for Kentucky

Published January 19, 2018

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Kentucky to add work and community engagement to its Medicaid eligibility requirements

On Friday January 12, 2018, the Federal Government approved a plan by Kentucky that will require a significant number of Kentucky Medicaid benefit recipients to participate in work or related activities in order to retain health coverage under the program. Kentucky was one of seven states that had requested a waiver from the Federal Government in order to modify their states’ administration of the program (Indiana being one of the seven as well). Kentucky is the first state to receive approval for this waiver request.

What does this mean for Medicaid recipients?

Included in the waiver was a request to add work and community engagement for Medicaid eligible participants as a requirement for Medicaid eligibility. Individuals deemed disabled, those with acute health conditions, children (below working age), pregnant women, and full-time students would be eligible for a work/community engagement waiver or exemption. Those individuals in the Medicaid program between ages 19 and 64 will be subject to the new requirement. Details on how and what level of documentation is required and what work or community involvement will qualify are still being discussed. The new requirements in Kentucky will go into effect in July of 2018.

Kentucky Governor Matt Bevin stated in a news conference that the waiver should not impact coverage for Medicaid recipients who qualified for coverage before the state expanded the program under the Affordable Care Act (“ACA”). In 2014, the ACA expanded the Medicaid program to include adults with annual income up to 138 percent of the federal poverty level (“FPL”). In 2018, the income level to meet the “138% of Federal poverty level” threshold for a family of four is $33,948. The waiver will not impact federal subsidies for monthly health care premiums provided for under the ACA for household incomes that fall between 100% and 400% of the FPL.

Seema Verma, administrator of the Centers for Medicare and Medicaid, said one of the major, fundamental flaws in the Affordable Care Act was putting able-bodied adults in a program that was designed for disabled people. Mrs. Verma went on to discuss that one-third of doctors do not accept Medicaid beneficiaries, as it is thought that reimbursement rates are too low. The ACA put over 10 million new people in the Medicaid program and the program was not designed for these populations and it has “stretched the safety net” for those it was designed for and jeopardized the program. She went on to say, “The program is not designed for able-bodied individuals and major changes are needed to make the program sustainable. “


Sources: Chris Larson, Louisville Business First and Stephanie Armour, The Wall Street Journal