|U.S. Rep. John Yarmuth|
Yarmuth said it's clear the Department of Health and Human Services will reject the plan because the agency recently rejected similar changes proposed by other states, Deborah Yetter and Tom Loftus report for The Courier-Journal.
"There is no longer any argument about the outcome of your strategy," Yarmuth told Bevin in a letter. "It will fail."
Yarmuth noted that Ohio's plan was rejected for its premium charges without respect to income and because it would create a large loss of coverage and that parts of Arizona's plan were rejected because of its premium requirements for individuals living below the poverty line, work requirements and its six month lock-out period for non-payment of monthly premiums. He said all of these rejected provisions are in Bevin's plan.
The plan, submitted under a waiver from federal rules that allows demonstration waivers, focuses on "able-bodied adults" who qualify for Medicaid under the expansion of the program to those who earn up to 138 percent of the federal poverty level.
The changes are meant to increase participants engagement in their health care through things like monthly premiums of $1 to $37.50, requirements that those who aren't primary caregivers work or volunteer up to 20 hours a week to keep coverage and "lockouts" of coverage for some who fail to pay.
Yarmuth said federal officials have told him that they will not accept this plan, citing the recent rejections of similar proposals. "There's no chance they are going to approve this waiver," he said.
Bevin has said the state cannot afford to have 1.4 million people on Medicaid. Of those, 440,00 are covered through the expansion. The expanded population is paid in full by the federal government through this year. In 2017, the state will be responsible for 5 percent of the cost, rising in annual steps to the reform law's limit of 10 percent in 2020.
And though Bevin has said he is willing to negotiate, he has also said that he would end the expansion if the federal government does not approve his changes.
Yarmuth implored him not to do that. "We want to make sure that Kentuckians understand exactly what's at stake – 10 percent of the people of this commonwealth who now have coverage are going to lose it," Yarmuth said.
Bevin's press secretary, Amanda Stamper, said in a statement that federal officials have "full authority" to approve Kentucky's waiver and Yarmuth's news conference was politically motivated.
"While Congressman Yarmuth plays politics three weeks before an election, Gov. Bevin and his team have spent several months developing a transformative and financially sustainable Medicaid plan that will actually improve health outcomes for Kentuckians and encourage self-sufficiency," Stamper said. "Gov. Bevin remain committed to working with the Centers for Medicare and Medicaid Services as long as it takes to transform Kentucky's Medicaid program to achieve these vital goals."
Yarmuth acknowledged that Bevin's actions represent what he promised during his election last year, but said he doubted voters believed he would do it, The Courier-Journal reports. A poll taken shortly after the election shows that most Kentuckians did not want the expansion scaled back.
Yarmuth also said if Bevin does make good on his promise to take away health coverage from 440,000 Kentuckians, he should "pay some political price. ... But that's not why we're here. We're here because our citizens will pay the price."