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Friday, February 5, 2016

Health cabinet offers no budget-cut details at committee meeting; legislators say they need this information to draft budget

Democrats on the state House Budget Subcommittee on Human Services pressed the Cabinet for Health and Family Services for more details on how it planned to implement Republican Gov. Matt Bevin's proposed budget cuts of 4.5 percent in the fiscal year that ends June 30 and 9 percent in the upcoming biennium, Kevin Wheatley reports for cn|2's "Pure Politics."

"The CHFS budget includes proposals to raise wages for social workers, assist community mental health centers and local health departments with rising retirement cost and increase funding for child advocacy centers, among others," Wheatley notes.

The budget will not cut Medicaid funding, Bevin said at his Jan. 26 budget speech, although his administration is negotiating with federal officials for changes to the program to make it less costly. In the same speech, he also promised to end the Medicaid expansion if this is not accomplished.

Former Gov. Steve Beshear, under federal health reform, expanded Medicaid to include those with incomes up to 138 percent of the federal poverty level to join the program. Since then, Medicaid has added about 425,000 Kentuckians to its rolls.

Secretary Vickie Yates Brown Glisson
CHFS Secretary Vickie Yates Brown Glisson told the committee Feb. 3 that her staff was "still considering what to cut within social services, public health, aging services, mental health and other key areas that fall within her cabinet," Deborah Yetter reports for The Courier-Journal.

Glisson said it would be early March before she would have more answers about the cuts, although she believed they would not impact the cabinet's essential services, Wheatley reported.

The lack of detail didn't set well with the lawmakers, Wheatley noted. Committee member Rep. Jim Wayne, D-Louisville, told Glisson that they needed this information sooner than that so the House, which originates the budget legislation, could have time to get it drafted and sent to the Senate for action.

“The process here is that we need to review this budget and we need to know its impact as soon as possible because we’ve started this process now, and essentially you’re saying, ‘I don’t have the information to give you to do the work that you as the committee members need to do,’” Wayne said. “So two weeks is really, in this process, I think is long.”

Rep. George Brown, D-Lexington, asked exactly how much it was going to cost the state to dismantle Kynect, the health-insurance exchange Beshear created, and move to the federal exchange. Beshear’s administration said moving to the federal exchange would cost the state $23 million, but Bevin has disputed that amount, apparently expecting the federal government to pay most of the bill.

Andrew McNeill, a senior adviser to Bevin, told the committee the administration had some "preliminary quotes" that weren't "anywhere close" to the previously cited $23 million, but couldn't share them because they weren't final. He also said the 1 percent assessment on insurers to pay for Kynect would be used to dismantle it.

Rep. David Watkins, a Henderson Democrat and retired physician, expressed his disappointment in losing Kynect, saying the exchange helped Kentuckians get coverage and often helped people discover they were eligible for Medicaid: "It is going to be much harder for them to sign up for the programs available to them."

Wheatley reports, "Glisson said the cabinet will have a new computer system available at its local offices for residents to enroll in health coverage through the federal exchange or in Medicaid. She also suggested that some 'Kynectors', or workers hired to help residents navigate the state exchange, could remain during the transition."

Rep. Addia Wuchner from Burlington was the only Republican lawmaker who spoke during Wednesday’s meeting, "praising Bevin’s budget proposal and saying that access to health care doesn’t necessarily improve health outcomes," Wheatley reports.

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