Health advocates urge Kentucky lawmakers to reconsider Medicaid work requirements

FRANKFORT, Ky. (FOX 56) — Health advocates hope to send a message to lawmakers about a bill making major changes to Kentucky’s Medicaid program.

“It is a way to cut costs because fewer people will be enrolled in Medicaid,” Kentucky Voices of Health Executive Director Emily Beauregard said during a Wednesday morning media conference on House Bill 695.

It’s a proposal supporters say will bring more transparency and accountability to Kentucky’s Medicaid system, but health advocates who were part of Wednesday’s conference warned the bill could create a barrier for the 1.4 million Kentuckians that rely on the safety net program

“One of the many kinds of funding options or options for cuts on the table is work reporting requirements. But I think that in and of itself tells you that a work requirement is a cut,” Beauregard said. She argued that at face value adding work reporting requirements sounds like common sense – but believes the added paperwork just adds confusion to the process.

While the bill doesn’t necessarily mandate this, it does direct the Cabinet for Health and Family Services to request approval from the federal government to initiate these requirements. The last time Kentucky went down this road was in 2018 when work requirements mandated by then-Governor Matt Bevin were blocked by a federal judge.  

“Our experience in the Bevin administration was incredibly complicated, and reporting requirements very difficult to meet, often resulting in people losing coverage. But not because they weren’t working. It was because they could not comply with the paperwork requirements,” Advocacy Action Network executive director Dr. Sheila Schuster said.

Schuster, a clinical psychologist, shared she’s also concerned that the bill’s return to requiring prior authorization for behavioral health services, which was suspended during the pandemic, could delay or reduce care.

Under the bill all of this would be overseen by a newly created Medicaid Oversight and Advisory Board, which Republican Senator Chris McDaniel said he expects to operate much like when Kentucky had to start reigning in its underfunded pension system.

“It will start out as adversarial, just like public pension oversight Board did. And you know what happened over the past seven or eight years as we’ve had public pension oversight board, we went from being adversaries with the pension systems to collaborating,” McDaniel said on the Senate floor as the bill was being debated on March 14.

Governor Andy Beshear vetoed House Bill 695 on Wednesday afternoon. Thursday and Friday are the final two days of the session, when lawmakers may also consider overriding any vetoes.