Lexington, Paducah newspapers' editorials take diametrically opposing sides on Bevin's proposed changes to Medicaid

Governor Matt Bevin (Photo from politicususa.com)

By Danielle Ray
Kentucky Health News

Kentucky's most reliably liberal editorial voice and one of its most reliably conservative are, not surprisingly, on opposite sides of Gov. Matt Bevin's plan to change the Medicaid program.

Bevin has proposed changes that would transition 86,000 Medicaid recipients to private insurance within five years, according to estimates from his administration. His proposal would require "able-bodied" recipients to pay a monthly premium of between $1 to $15, depending on income. If a person wanted dental or vision insurance, he or she would have to do such things as enroll in a community-college course, get a job or enroll in a smoking-cessation program.

The Lexington Herald-Leader published an editorial Sunday that calls Bevin's proposed changes a "red-tape tangle of penalties, incentives, premiums and cutbacks in coverage." The newspaper argues that the plan would create new administrative costs while caring for fewer Kentuckians.

The Herald-Leader does not reject the governor's plan wholesale. It applauds certain aspects, such as creating rewards for quitting smoking. It also backs Bevin's pilot program that would expand access to residential treatment for addiction and mental illness in 20 counties in an effort to quell the state's drug abuse epidemic and prevent the spread of hepatitis and HIV.

And the paper likes Bevin's renegotiation of contracts with Medcaid managed-care companies, which administration officials say will save taxpayers $280 million over the next six months. The state's five managed-care firms earned far higher profits than their counterparts in every other state in 2015, the research group Milliman reports.

Jim Paxton, publisher of The Paducah Sun, welcomes the governor's proposed changes. His editorial, which is behind a membership paywall, in Sunday's Sun says change is needed because then-Gov. Steve Beshear added more than 400,000 Kentuckians to the program, something that Bevin, Paxton and many other conservatives see as unsustainable. Paxton says one of every four Kentuckians now qualifies for Medicaid, which he implicitly deems unacceptable.

The federal government is picking up the full tab for the expansion under through this year, under federal health reform. Next year, the state will begin paying 5 percent of the cost, rising in annual steps to the law's limit of 10 percent (expected to be more than $360 million) in 2020. Paxton says Bevin was elected to clean up Beshear's mess and calls his plan "a creative, fair and rational step to do so."

The public may send comments on Bevin's plan to Medicaid Commissioner Stephen Miller or email kyhealth@ky.gov by July 22. A public hearing was held Tuesday in Bowling Green. Hearings will also be held Wednesday in Frankfort and July 6 in Hazard.