At public hearing, most oppose proposed Medicaid changes
By ADAM BEAM
Jul. 17, 2017
FRANKFORT, Ky. (AP) — As a nanny for triplet girls, Clare White depended on Medicaid to pay for the mental health prescriptions she said she needs to keep from killing herself.
The kids grew up, and White lost her job about two months ago. She's been looking for a job since then, but thanks to Medicaid, she has not lost her coverage. That could change under a proposal from Republican Gov. Matt Bevin, who is seeking to overhaul the state's Medicaid program to require people like White to have a job or volunteer in the community in order to keep their benefits.
State officials estimate the changes could reduce Kentucky's Medicaid enrollment by 95,000 people by 2021.
"I am told on a regular basis that I am entitled, that I want everything handed to me, that I lack gratitude. Nothing can be farther from the truth," she said. "I am eager for the day that I earn my own benefits and bring home a paycheck that enables me to move out of my parents' house and even afford to start a family."
White was one of 17 people who spoke during a final public hearing Monday on Bevin's proposed Medicaid changes. Bevin's proposal would require most people in Kentucky's expanded Medicaid program to either work or volunteer for 20 hours a week to keep their benefits. The plan would cut automatic access to vision and dental coverage but give people the opportunity to earn that coverage back through a rewards program.
Most of the people who spoke Monday opposed the program, including The Rev. Kent Gilbert, who called it "reprehensible and immoral." But Vickie Yates Brown Glisson, the secretary of Kentucky's Health and Family Services Cabinet, said the comments showed most people don't understand how the program would work. In Clare White's case, Glisson said as long as she is actively looking for a job and "trying to improve her skills" she would meet the work requirement and not lose her coverage.
"That's the hard part about the comment period. You hear folks say things and you want to say, 'I don't want you to worry,' or 'It's OK,'" she said. "I likewise feel very strongly we are doing the right thing for Kentucky, so I'm very comfortable."
Bevin's changes would not apply to everyone. Children younger than 19, pregnant women, primary caregivers for children or disabled adults, the medically frail and full-time students would be exempt.
The proposal must first be approved by the federal government. The governor submitted it last year when Barack Obama was still president. Earlier this month, he made some changes and re-opened the public comment period, delaying any action by the federal government until August at the earliest. But it appears the Trump administration is willing to approve Bevin's request. Speaking in Lexington last week about Bevin's proposal, Vice President Mike Pence said: "President Trump and I are going to make sure that (Bevin) has the chance to try."
The proposal comes as lawmakers in Congress debate a pair of proposals that would repeal the federal Affordable Care Act and effectively eliminate the expanded Medicaid program over the next decade. It's unclear how that would affect Bevin's proposal. State officials said it would not alter their request.
Kentucky's expansion brought taxpayer-funded health coverage to an additional 440,000 people and cut the state's uninsured rate to 7 percent. But it will also increase the state's costs by nearly $300 million beginning in January, prompting Bevin and other Republicans to say the state cannot afford to keep the program without changes.
Not all Medicaid recipients opposed the changes. Johnny Pittman relied on Medicaid and disability benefits after he was diagnosed with multiple sclerosis, a disease that attacks the central nervous system. He's off of those federal programs and works for Oxmoor Auto Group in Louisville.
He said the proposed changes would encourage people to work, which is "the biggest thing that the state of Kentucky is doing right now."
"Disability and Medicaid worked great for me. It was a program and a vehicle to get me to a point where I needed to be," he said. "We can help you through this, but you need to be responsible for yourself."