Bevin's Medicaid plan protested before hearing

FRANKFORT, Ky. - As someone who works long shifts at a restaurant while putting in at least 20 hours each week trying to launch an outdoor adventure business, Tyler Offerman said he opposes Gov. Matt Bevin's proposed changes to Medicaid.

"To assume that people like me are lazy or mooching off the system is totally offensive," said Offerman, 27, of Lexington, who gained health coverage in 2014 after Kentucky expanded Medicaid under the Affordable Care Act. "The Bevin administration plan would be a disaster for me."

A dozen people - including a Roman Catholic priest, a nun, a physician, a farmer and others telling their stories about health coverage - gathered in Frankfort on Wednesday to protest Bevin's proposed changes to the federal-state health plan.

"Health care policy must protect human life and dignity," said the Rev. Dan Noll, a priest from Lexington representing the Catholic Conference of Kentucky. "Gov. Bevin's proposal is not a health care policy. We oppose it wholeheartedly."

The speakers appeared at a news conference organized by the group called "Keep Kentucky Covered," which seeks to retain the state's expansion of coverage under the federal health law also known as Obamacare.

It came just before a meeting of the joint House-Senate Health and Welfare Committee where officials gave a presentation of Bevin's proposal for a waiver, or permission from the federal government, to reshape the Medicaid program. Bevin has said he wants to create a program that will increase cost-sharing by consumers, improve health and encourage more personal responsibility or "skin in the game."

The proposal seeks to charge premiums for coverage that is now largely free, adds requirements that people work or volunteer to get benefits and would "lock out" some people who miss premium payments. It also eliminates dental and vision care from basic Medicaid coverage though consumers could accumulate points on a "rewards" card toward purchases of optional health and dental services.

It would restructure the program created under executive order by Bevin's predecessor, Democrat Steve Beshear, that expanded the state's Medicaid program to cover anyone up to 138 percent of the federal poverty level, about $16,200 a year for an individual. The expansion added 440,000 Kentuckians to the program's rolls.

Bevin has called the program "unsustainable" and has pledged to change it.

Speakers at Wednesday's news conference objected to Bevin's proposed changes, pointing out that most people covered under the expansion already work but don't make enough money to pay for health care or have jobs that don't provide it.

That includes Bree Pearsall, who runs a farm in Oldham County with her husband. Too busy to leave the farm Wednesday, Pearsall sent in a written statement to be read aloud.

"The work requirements of the new proposal feel like a slap in the face to hard-working families like mine," said Pearsall, who said she and her husband rise at 6 a.m. and usually work till dark.

The family initially purchased a health plan through kynect, the state health exchange also created by Beshear that Bevin plans to dismantle. Currently, the family's income is low enough that it qualifies for Medicaid despite the hard work, Pearsall said.

"This is my skin in the game," Pearsall said.

Sister Mary Joyce Moeller, with the Divine Providence order, said she and other Catholic sisters have worked for years in southeastern Kentucky, a region with some of the state's highest poverty rates and lowest educational attainment.

Many of those she's worked with have jobs but make low wages or work two or three part-time jobs just to survive, Moeller said.

She called Bevin's proposal, with co-pays or premiums, work requirements and other demands "cumbersome and unworkable."

"If this plan goes into effect as it is, I believe many will lose their health insurance," she said.

And William Grimes, a Catholic deacon in the rural eastern Kentucky town of Owingsville, said he and others started a free clinic 16 years ago to meet the needs of the many local residents with no health coverage. Within two years, they had added 3,000 patients, he said.

With the expansion, "about 1,000 of my patients got Medicaid," Grimes said. "That was wonderful."

Grimes said most of the patients his clinic sees are desperately poor and could not even afford the modest monthly premiums of $1 to $15 per month that Bevin proposes. The clinic tries to stock free medicine because most of those with no insurance don't have a few dollars for a generic prescription.

"There are some people this skin in the game might help but for the patients I work with, they can't afford it," he said.

Dr. Eli Pendleton, a Louisville physician with University of Louisville Family Medicine, said the state already is achieving goals of improving poor health as more people gain coverage, some for the first time in their lives.

"I worry that Gov. Bevin's plan will erase all this progress," he said.

Later Wednesday, officials with the Bevin administration outlined the Medicaid proposal in greater detail before the Health and Welfare Committee.

Medicaid Commissioner Steve Miller said the goal of the "Medicaid transformation" is to get people more engaged in their health and become more responsible about health choices as well as saving money. It has the potential to save up to $2.2 billion over five years, $1.9 billion of that in federal money that funds the majority of Kentucky's Medicaid spending, he said.

Committee members offered conflicting views, largely along party lines.

Rep. Tom Burch, a Louisville Democrat and committee co-chairman, said he thinks Bevin's plan is ill-advised.

"I think what they're offering is a dangerous precedent,'' he said. "If you've never been poor, you don't understand what it means to get a dollar. People out there are poor."

But Sen. Danny Carroll, a Paducah Democrat, said he supports Bevin's goals.

"This waiver is about personal responsibility," he said. "I think it's time to start looking at the handouts and start limiting them to the people who actually need it."

Contact reporter Deborah Yetter at 502-582-4228 or dyetter@courier-journal.com.