HAZARD — A public hearing was held Wednesday at HCTC to discuss changes the Bevin Administration has proposed for Medicaid in Kentucky. Hazard served as an appropriate setting for the meeting, considering the fact that Southeastern Kentucky, and Perry County in particular, rank high statistically in terms of patients struggling with the nation’s most troubling health issues, including cancer and diabetes. Southeastern Kentucky also claims a large number of participants in the state’s Medicaid system. Only three public hearings were held in all of Kentucky to address this issue; one in Bowling Green; one in Frankfort; and the final meeting in Hazard.
Gov. Bevin is seeking to undo some of the expansions Medicaid in Kentucky received as a result of the Affordable Care Act. In his efforts to obtain a Medicaid waiver from the federal government, Bevin argues that the expansions are too expensive for Kentucky. However, a decrease in Medicaid funding could result in hundreds of thousands losing at least some, if not all, of their health benefits. An estimated 440,000 Kentucky citizens have gained healthcare coverage under the Medicaid expansion. Bevin argues that the proposed waiver will not only make healthcare more affordable for the state, but it will also help create a plan that provides better health benefits. Attendees of Wednesday’s hearing, however, voiced major concerns that the waiver would do the exact opposite.
Proposed changes to dental and vision coverage are highlighted by many of those opposed to Bevin’s plan. At the Hazard hearing, citizens and representatives from the medical profession expressed worries that downsizing Kentucky’s Medicaid could be catastrophic, especially to senior citizens in the region. Similar opinions were also shared at the previous hearings in Bowling Green and Frankfort.
State Rep. Fitz Steele released this statement about the proposed Medicaid waiver:
“The entire state must work together to ensure that all our citizens receive appropriate healthcare. To the extent that the Medicaid Waiver proposal provides continued care, I am in favor of that.
Some preventative care is covered under the waiver, but the key elements of dental and vision screenings are eliminated from basic coverage. Those inexpensive tests provide vital front line diagnostics for adult insureds. Dangerous and deadly health conditions like diabetes, cardiovascular disease and cancer are discovered or prevented by simple annual visits to the eye doctor or dentist. I encourage the amendment of the waiver to include annual dental and vision checkups for everyone receiving covered care under the waiver.
The waiver focuses on the goal of education and employment for every able Medicaid recipient. Yet the waiver eliminates coverage for hearing aids. If you can’t hear, you can’t learn or work. Hearing aids are an inexpensive assistance with a huge positive impact. I encourage amendment of the waiver to cover hearing aids.
Substance abuse is a key issue that the waiver addresses. I encourage the waiver to focus on an increase in qualified intensive outpatient care and not just limited in-patient care. Outpatient care allows patients to obtain the treatment they need while still being able to parent their children and maintain employment. This benefits everyone by keeping the family together and ensuring that the patient can still work and contribute to society.”
Bevin is seeking a plan, which requires what he refers to as “able-bodied” citizens, to work at least 20 hours per week or participate in some form of community service. The plan, if enacted, will also add premiums and cut benefits in certain cases. Rewards will be available for people who participate in a financial literacy course or a health assessment. Currently, Medicaid in Kentucky runs at a cost of approximately $10 billion per year and provides coverage for more than 1 million citizens, which accounts for nearly a quarter of all people living in the state.
Medicaid Commissioner Steve Miller and the Governor’s Cabinet Secretary Scott Brinkman were present at the hearing, which attracted almost 150 attendees from Perry and surrounding counties. Bevin’s plan is not a done deal. In fact, the plan faces tough hurdles to cross from the federal government. The feds have rejected similar proposals from other states in the past.
Sam Neace can be reached at 606-629-3243 or on Twitter @HazardHerald.