Kentucky to add Medicaid work requirement; first state to follow Trump plan

Kentucky Gov. Matt Bevin announces federal approval of Kentucky's Medicaid waiver in the Capitol Rotunda in Frankfort, Ky., Friday, Jan. 12, 2018.  (Alex Slitz/Lexington Herald-Leader via AP)

Kentucky received the green light Friday to require many of its Medicaid recipients to work in order to receive coverage.

The Bluegrass State thus becomes the first state to act on the Trump administration’s unprecedented change that could affect millions of low-income people receiving benefits.

Under the new rule, adults age 19 to 64 must complete 80 hours of "community engagement" per month to keep their care. That includes working a job, going to school, taking a job-training course or volunteering.
"There is dignity associated with earning the value of something that you receive," Kentucky Gov. Matt Bevin said. "The vast majority of men and women, able-bodied men and women ... they want the dignity associated with being able to earn and have engagement."

"There is dignity associated with earning the value of something that you receive. The vast majority of men and women, able-bodied men and women ... they want the dignity associated with being able to earn and have engagement."

- Kentucky Gov. Matt Bevin

Kentuckians also will be required to pay up to $15 a month for their insurance, with basic dental and vision being eliminated entirely. However, those benefits can be earned back through a rewards program, such as getting an annual physical, completing a diabetes or weight management course or participating in an anti-smoking program.
The change was approved Friday by the Centers for Medicare and Medicaid Services.
The Trump administration announced Thursday it would allow for states to impose work requirements for people receiving Medicaid.
Bevin, a Republican, said the decision stemmed from concern about public health. Despite the fact that more Kentuckians have insurance, they’re not becoming any healthier, he said.
The state, along with the rest of Appalachia, falls behind the rest of the U.S. in 33 out of 41 population health indicators, according to a recent study. Bevin believes the new work requirement will help change the statistic.
Bevin’s office also stated in its proposal to Washington that the move will save taxpayers more than $300 million over the next five years, and estimated that up to 95,000 people could lose their benefits because they either didn’t comply with the new rule or they obtained jobs that pay too much money and push them out of the low-income bracket.
However, there are some exemptions to the work requirements that will be enforced starting in July and remain in effect for five years. Pregnant women, full-time students, former foster care youth, primary caregivers of children and the elderly and full-time students will not be affected.
People deemed “medically frail,” a broad term that encompasses people who are battling drug and alcohol addiction, will also be exempt.
Critics of the new plan said the changes could lead to many low-income families being denied needed coverage because of technicalities and challenging new paperwork.
Democratic U.S. Rep. John Yarmuth, who represents Louisville, calling it a “dangerous and irresponsible” decision that will lead to the “financial ruin” or thousands of families that reside in Kentucky.
Medicaid covers more than 70 million people, or about one in five Americans. Currently, the largest government health insurance program does not required people to have a job or be employed to receive the benefits.