Dive Brief:
- Kentucky has announced it's cutting vision and dental coverage for as many as 460,000 people on Medicaid following a federal judge's decision last week to reject its CMS-approved plan tying benefit eligibility to work requirements.
- The state Cabinet for Health and Family Services called the cuts an "unfortunate consequence" of the ruling on Kentucky HEALTH, which would have required people to remain employed in order to receive Medicaid benefits.
- In defending the work mandate, Republican Gov. Matt Bevin said the program would have alleviated an anticipated $300 million shortfall in Medicaid over the next two years by reducing the state's Medicaid population by about 100,000 and saving $2.4 billion.
Dive Insight:
In his ruling last week, U.S. District Judge James Boasberg called into question whether or not Kentucky considered how Kentucky's program would affect the goals of Medicaid and the state's population health.
According to a statement from CHFS spokesman Doug Hogan, Medicaid members received a notice that effective July 1, their dental and vision coverage would only be available through a Kentucky HEALTH rewards program. When Kentucky HEALTH was rejected by the court, that program became "invalidated." Without a funding mechanism in place to cover vision and dental, members lost access to coverage.
That explanation isn't cutting it for critics calling the Republican state administration's decision a malicious response to the federal court's ruling.
Former Obama administration CMS chief Andy Slavitt said Bevin is "sending a message and using his power to make sure people suffer."
BREAKING: KY governor Bevin cuts 500,000 Medicaid beneficiaries off of dental & vision care.
— Andy Slavitt (@ASlavitt) July 2, 2018
Last week he lost a court case to take Medicaid from 100,000.
He is sending a message and using his power to make sure people suffer.
According to Hogan, the state "made it clear" that dental and vision were dependent on Kentucky HEALTH, and "without the waiver, immediate benefit reductions would be required to compensate for the increasing costs of expanded Medicaid."
Hogan did not respond to Healthcare Dive's question about how much the state anticipates saving once the cuts are made. However, CHFS released a statement following news coverage on July 2 arguing that the cuts are a temporary problem, that fewer than 10% of Medicaid beneficiaries have taken advantage of their dental and vision coverage, and that the Cabinet only had "30 hours to undo 1 ½ years of meticulous planning."
The state administration is still hopeful that Kentucky HEALTH will get the green light once it resolves "the single issue" raised by the federal judge, and the rewards program from which members can access dental and vision is reinstated.
"Once we ultimately prevail in this legal challenge and Kentucky HEALTH moves forward," Hogan said, "Then beneficiaries will have access to these optional services."