Beshear urges no 'back room' Medicaid deals
Demanding an end to "back room deals," former Gov. Steve Beshear is calling on Gov. Matt Bevin to include the public in his plans to reshape the state's expanded Medicaid program under the Affordable Care Act.
Beshear, in a joint letter to Bevin and U.S. Health and Human Services Secretary Sylvia Burwell, also asks the federal government, which funds the majority of Kentucky's Medicaid costs, to disclose any changes sought through a "waiver" the federal agency must approve.
"We demand the Bevin and Obama administrations pull back the curtain, stop the back room deals and allow for full disclosure and transparency throughout the development of this Medicaid waiver proposal that will impact the lives of hundreds of thousands of Kentuckians," Beshear said, writing on behalf of the organization he founded called "Save Kentucky Healthcare."
About 425,000 Kentuckians have signed up for Medicaid under the federal expansion that allows anyone earning 138 percent or less of the poverty level to enroll, an annual income of about $16,200 for an individual.
Beshear, a Democrat, whose health care expansion is considered a signature accomplishment of his administration, has been sparring over the subject with Bevin, a Republican who succeeded him in December. Bevin has pledged to shut down kynect, the state's online health exchange, and scale back the Medicaid expansion he said will be too costly once the federal government stops paying 100 percent of the cost in 2017.
A Bevin spokeswoman on Monday declined to comment on the Beshear letter.
Brain injured man gets benefits restored
But a spokesman for Burwell indicated any changes to Kentucky's Medicaid plan should not weaken it.
"Kentucky's Medicaid expansion has led to one of the biggest reductions of uninsured people in America, and any changes to the program should maintain or build on the historic improvements Kentucky has seen in access to coverage, access to care and financial security," said Ben Wakana, national press secretary for the U.S. Department of Health and Human Services.
Federal regulations require state officials to hold at least two public hearings on the proposal to change Medicaid before submitting it to the Centers for Medicare and Medicaid Services (CMS) for approval. The state must also accept public comments for 30 days prior to submitting it.
Once CMS reviews Kentucky's application for the waiver, it accepts public comments for another 30 days.
But some advocates say they need to be involved much sooner in helping design any changes to Medicaid rather than be limited to comments after a plan has been proposed.
"It's important that we have an opportunity to have input into this plan," said Emily Beauregard, executive director of Kentucky Voices for Health, a coalition of health advocacy groups.
Kentucky has been hailed as a national model through its implementation of the federal health law, most recently in a study by the Kaiser Family Foundation. The research brief released in April found that "Kentucky has had one of the most successful ACA implementations in the country."
Rants and raves | Beshear vs. Bevin
The study listed Kentucky's sharp reduction in the rate of uninsured residents, effective marketing and a successful launch of kynect, which consumers use to purchase private health plans or sign up for Medicaid.
Bevin plans to dismantle kynect and transition people shopping for private health plans to the federal site, healthcare.gov. People seeking to enroll in Medicaid would use benefind, the state's new public benefit system.
He also wants to restructure the Medicaid program, which he has called "unsustainable." Bevin has proposed following Indiana's plan, which imposes more cost-sharing through co-payments and premiums and penalties such as "lock outs" for some who don't pay.
Beshear's call for more public involvement in proposed changes to Kentucky's Medicaid program comes as an outside group holds a "stakeholder" meeting this week on the subject for health consumers, providers and others who would be affected.
Foundation for a Healthy Kentucky, a non-partisan organization that works to improve access to health care, is holding the one-day event Thursday and will be happy to share its findings with the Bevin administration, said Susan Zepeda, the foundation's executive director. Zepeda said the foundation believes it's important to get people involved early before a final proposal is released.
"We feel that Medicaid is something that reaches throughout Kentucky," Zepeda said. "We think it's part of our mission that many voices are heard in a policy decision that affects the health of Kentucky."
Contact reporter Deborah Yetter at (502) 582-4228 or at dyetter@courier-journal.com.
