Bevin cuts dental, vision benefits to nearly 500K Medicaid recipients

Deborah Yetter | Courier Journal

Show Caption Hide Caption Louisville Democrats speak out against Matt Bevin's Medicaid cuts Louisville group speaks out against Gov. Matt Bevin's cuts to Medicaid cuts on Monday,

Gov. Matt Bevin's administration announced it is cutting Medicaid dental and vision benefits to nearly half a million Kentuckians after a judge on Friday rejected his plan to overhaul the government health plan.

The decision prompted an outcry Monday from Democrats who called the Republican governor's move rash, harsh and possibly illegal.

"We've got to have the public rise up," said U.S. Rep. John Yarmuth of Louisville. "This is going to be extremely dangerous for the citizens of the Commonwealth of Kentucky."

On Sunday, the Bevin administration in an email described the cuts as "an unfortunate consequence of the judge's ruling."

On Monday, it followed with a statement saying it was "working through" impacts of the judge's order and that it hopes to "quickly resolve the fallout from the court ruling."

Democrats including Yarmuth, Louisville Mayor Greg Fischer, several state legislators and Louisville Metro Council President David James held a press conference to denounce the cuts, which were made after Bevin's Medicaid overhaul was rejected by a federal judge in Washington D.C.

Medicaid, an $11 billion-a-year health plan in Kentucky, covers about 1.4 million people, more than 600,000 of them children. The federal government provides about 80 percent of the money for Kentucky's Medicaid program.

Bevin's changes to Medicaid that include work requirements, premiums and other new rules, were to take effect Sunday.

But on Friday, U.S. District Judge James E. Boasberg vacated Bevin's entire plan and sent it back to officials at the U.S. Department for Health and Human Services for further review, The judge said the Trump administration, in approving the plan, didn't consider the basic provisions of federal Medicaid law, which is to provide access to health care for low-income and vulnerable citizens.

Speakers on Monday expressed outrage at Bevin's cuts.

Fischer called Bevin's actions "unnecessary and callous." State Sen. Gerald Neal called the cuts "not only a rash step, but a harsh step."

And state Rep. McKenzie Cantrell, a Democrat from South Louisville, said the impact is hardest on the many poor people covered by Medicaid who work at low-wage jobs and are struggling to keep up with all the changes.

"It's red tape for poor people," she said.

Background: Federal judge strikes down Matt Bevin's effort to overhaul Medicaid

Jennifer Hasch, who manages dental services for the Shawnee Christian Health Center, implored state officials to consider the impact on low-income people in need of dental treatment.

"We are deeply concerned for our patients and the sustainability of dental services at our clinic," she said.

The news created confusion among local clinics that provide dental services to Medicaid patients, including Louisville's Family Health Centers, a network of community health clinics.

"We'll continue to see patients," said Bill Wagner, CEO of the clinics. But he said that if Medicaid stops covering dental services, the clinics likely will have to start charging a basic fee of $30 per visit, an amount some can't afford.

Several speakers Monday questioned whether it's legal for Bevin to abruptly cut dental and vision coverage for nearly one-third of the 1.4 million Kentuckians covered by the federal-state health plan. Yarmuth said his office is seeking an opinion from the U.S. Centers for Medicare and Medicaid Services, or CMS, the agency that oversees state Medicaid programs,

"We don't think he can do that, " Yarmuth said. "We checked with CMS — they said they don't know if he can do that."

Cantrell, a lawyer, questioned whether the move would withstand a legal challenge.

"The governor's losing left and right in the courts these days," she said.

Rep. Joni Jenkins, a Shively Democrat, said lawmakers will ask the Cabinet for Health and Family Services, which administers Medicaid, for more details. That will include authorization for cutting benefits.

"We expect Medicaid beneficiaries to follow the rules," Jenkins said. "It's only fair that the cabinet follows the rules."

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Bevin's plan to reshape Medicaid in Kentucky is aimed largely at the "able-bodied" adults among about 500,000 people added since 2014 under an expansion authorized by the Affordable Care Act. The governor's plan would require people to work or volunteer at least 20 hours a week and pay monthly premiums of $1 to $15.

Under Bevin's plan, dental and vision benefits were eliminated but participants could earn points toward paying for such services through a "My Rewards" account by completing activities such as online classes or volunteer work.

Friday's ruling striking down the plan followed a legal challenge on behalf of Kentucky Medicaid beneficiaries who argued the changes are outside the scope of federal Medicaid law.

An email Sunday from the Cabinet for Health and Family Services said that under Bevin's plan, known as Kentucky HEALTH, about 460,000 Medicaid members affected by the changes already had been notified that effective July 1, basic dental and vision benefits would end.

"When Kentucky HEALTH was struck down by the court, the 'My Rewards Account' program was invalidated, meaning there is no longer a legal mechanism in place to pay for dental and vision coverage for about 460,000 beneficiaries who have been placed in the Alternative Benefit Plan," the email said. "As such, they no longer have access to dental and vision coverage as a result of the court’s ruling."

Bevin, who was elected in 2015, has been highly critical of the Medicaid expansion enacted by his predecessor, Democrat Steve Beshear.

Adam Meier, secretary of the health cabinet, first mentioned the prospect of cutting benefits should the state lose a court challenge to the Medicaid overhaul last month at a legislative committee meeting.

Read this: Ask your questions, Gov. Matt Bevin tweeted. So people did.

Meier said the state was considering cutting vision, dental and possibly prescription drug benefits for those who would have been affected by the state's Medicaid changes. Most people covered by "traditional Medicaid" — pregnant women, children, disabled people and low-income elderly individuals in nursing homes — would not be affected.

The cabinet's statement Sunday said that with Bevin's overhaul delayed, "immediate benefit reductions would be required to compensate for the increasing costs of expanded Medicaid."

Deborah Yetter: 502-582-4228; dyetter@courierjournal.com; Twitter: @d_yetter. Support strong local journalism by subscribing today: courier-journal.com/deborahy.