New rules to impact over half of county

Over half of Knox County may be affected by a decision that put Kentucky at the front of the line when it comes to Medicaid reform.

When the federal government announced last week it would allow states to force eligible Medicaid recipients to work in some capacity to keep their health coverage, reactions were mixed at best.

Governor Matt Bevin called the approval “transformational” on Friday, with Kentucky becoming the first state to adopt the new rules to receive Medicaid benefits. “I am excited by the fact that Kentucky will now lead the nation,” said Bevin.

However, if health advocacy groups and Democrats challenge Bevin’s plan, and the courts strike it down, the Governor has threatened to eliminate the Medicaid expansion program, stripping coverage from 5,486 people in Knox County. Statewide, that total is over 400,000. “The Commonwealth will not be able to afford to continue to operate its Medicaid expansion program as currently designed in the event any one or more of the components of (the new program) are prevented by judicial action from being implemented,” Bevin said Tuesday.

Of Knox County’s 18,032 Medicaid recipients (as of July 2017), 59% are already working either part-time or full-time jobs. Of the remaining 41%, many will have to find work or risk losing their coverage.

The Kentucky plan requires individuals to spend a total of 80 hours per month either working, looking for work, volunteering, job training, going to school or taking care of someone who is disabled. The new plan does not apply to those classified as “medically frail,” pregnant women, homeless or those who have a substance-abuse disorder.

Bevin stressed the benefits associated with working for the benefits would affect people on a personal level. “There is dignity associated with earning the value of something that you receive,” Bevin said.

According to the Kaiser Family Foundation, most Medicaid recipients in fact work full-time or part-time jobs, making up about 57% of Medicaid recipients nationwide.

A requirement to pay small monthly premiums will also affect Medicaid recipients, with monthly premiums ranging from $1 per person to $15 per family, depending on income. People with disabilities, pregnant women, children, caregivers and former foster children under age 26 will not have to pay.

A source with Barbourville ARH reports that Medicaid patients account for about 40% of it’s customers.

While the premiums won’t take effect until July 1, 2018, work requirements will be phased in and recipients will get 90 days advance notice before rules take effect. According to Kentucky Health News, “Members will be required to report changes in their income, employment or community-service status within 10 days, and failure to do so would result in a six-month disqualification. Disenrolled members could re-enroll earlier if they complete a financial- or health-literacy course, unless they have defrauded Medicaid.”

Kentucky Health News contributed to this article.