- CMS has reopened public comment on its approval of Kentucky's Medicaid expansion waiver project Kentucky Helping to Engage and Achieve Long Term Health (KY HEALTH) after a federal judge earlier this month invalidated the agency's approval of the waiver.
- U.S. District Judge James Boasberg called into question whether or not Kentucky considered how its program would affect the goals of Medicaid and the state's population health. Kentucky responded to the court decision by axing vision, dental and non-emergency medical transportation (NEMT) for thousands of Medicaid recipients, but this week reinstated those benefits.
- "Although an additional public comment period is not legally required," the public comment page reads, "CMS is conducting one to ensure that interested stakeholders have an opportunity to comment on the issues raised in the litigation and in the court's decision."
Judge Boasberg's decision seemed less rooted in Kentucky HEALTH failing to meet procedural requirements and more based on the impact of the program itself.
HHS Secretary Alex Azar "must adequately consider the effect of any demonstration project on the state’s ability to help provide medical coverage," Boasberg wrote in his ruling. "He never did so here."
The Trump administration has been angling to allow more states to tie Medicaid benefits to work requirements through waivers. Late last week, the administration's Council of Economic Advisors published a report explaining what it believes the benefits of such a program would be if more states were to apply for waivers and implement work requirements.
A recent Kaiser Family Foundation report predicted 1.4 million to 4 million individuals would lose health coverage if work requirements were scaled nationally to the Medicaid program. Seven states are currently awaiting approval for Medicaid waivers which include work requirements.
Kentucky was slated to be the first state to introduce Medicaid work requirements. That title now belongs to Arkansas, where 7,000 Medicaid enrollees have just failed to meet work requirements and are in danger of losing coverage.
Kentucky had estimated its five-year demonstration project would reduce its Medicaid population by about 100,000 recipients and will save $2.4 billion.
CMS Administrator Seema Verma expressed disappointment in a statement released after the court's decision on Kentucky's waiver program earlier this month. "States are the laboratories of democracy and numerous administrations have looked to them to develop and test reforms that have advanced the objectives of the Medicaid program," Verma said.
The left-leaning Urban Institute estimated more than 43,000 people in Kentucky who at least temporarily lost NEMT benefits don’t have access to a car.
“To achieve a central goal of Medicaid, which is to ensure Kentuckians can access medical care, transportation must be a key consideration," Dustin Pugel of the Kentucky Center for Economic Policy wrote. "Without it, Medicaid members are forced to choose whether to use ambulances for transportation or forgo care.”
The federal public comment period is open until August 18.