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Kentucky HEALTH Medicaid Reform Proposal

June 22, 2016
By Kentucky Governor's Office

Health Care News reported in August 2016:Kentucky Gov.

for sale sign

Health Care News reported in August 2016:

Kentucky Gov. Matt Bevin (R) has requested the Centers for Medicare and Medicaid Services (CMS) approve Kentucky HEALTH, a reform of the state’s Medicaid and Medicaid expansion programs that would require able-bodied recipients to pay monthly premiums of $1 to $15, depending on their income levels, and incentivize them to reduce their health care spending.

The state would pay for all out-of-pocket health care costs of recipients.

People who have worked at least one year for an employer offering a health insurance plan would be required to enroll in the employer’s plan.

People without access to employer-sponsored health insurance would be enrolled in a “High Deductible Health Plan Equivalent to Kentucky State Employees’ Health Plan,” according a Kentucky HEALTH overview released by Bevin’s office on June 22.

The “high deductible” would cost $1,000. Using an account provided and fully funded by the state, a recipient would pay for their first $1,000 of medical expenses, “expos[ing] members to the cost of care and encourage[ing] cost-conscious healthcare decisions,” the overview states. The state would also pay for all medical costs exceeding $1,000.

At the end of each year, the state would transfer half of any unused deductible balance to each recipient’s “My Rewards Account,” which could accrue up to $500 each. Recipients would earn their reward in cash by exiting Medicaid and joining a commercial health insurance plan for at least 18 months.

Kentucky HEALTH would require members to engage in work-related or volunteer activity for 20 hours per week and make premium payments within 60 days of their due date, or else face a financial penalty or disenrollment.