|Gov. Matt Bevin|
“Do I think the presidential election will affect that? Oh, you betcha,” Bevin said at a Nov. 29 press conference. “And do I think it will increase the odds of this being approved? I do, and in fact what I think you are going to see is a devolution of responsibility from the federal level down to the state level.”
Another reason the plan may pass under a Trump administration is that Seema Verma, Trump's choice to head up the Centers for Medicare and Medicaid Services, was an advisor to the Bevin administration in constructing the state's new plan, Fortune magazine reports. To date, proposals in other states with similar provisions as Kentucky's new plan have not been approved.
Bevin said the Medicaid proposal is still under negotiation with federal officials and didn't know if the Obama administration would weigh in on it, though he thought they may approve the part that deals with opioid abuse, Jack Brammer reports for the Lexington Herald-Leader.
He also said he had talked to Trump and vice-president-elect Mike Pence about the role of states in developing health-care plans, but not about the proposal. Brammer writes, "States are likely to see more block grants from the federal government to decide how health dollars are spent, he said."
Bevin has said Kentucky can't afford to pay for the expansion of Medicaid to those who earn up to 138 percent of the federal poverty line, done in 2014 by former Gov. Steve Beshear, a Democrat, under federal health reform. The expansion has added about 440,000 Kentuckians, most of them working low-paying jobs that don't offer health insurance, to the Medicaid rolls.
The expanded population is paid in full by the federal government through the end of 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.
Bevin's proposal says it "is expected to save taxpayers $2.2 billion over the five-year waiver period," by reducing enrollment in the program, but only $331 million of that would be state tax money, because the federal government covers the bulk of Medicaid costs.
The proposal, among other things, would charge monthly premiums, require non-disabled recipients to work, earn a GED or to do community service, and require some of the currently covered benefits, like vision and dental, to be earned through a rewards program. Click here to see the report.