Starting on Sunday, Kentuckians with Medicaid who gained coverage because of the expansion will lose access to dental and vision benefits following a Friday court ruling striking down Gov. Matt Bevin’s changes to the program.

This applies to adults who became eligible for Medicaid when it was expanded, including adults without dependents who the state considers “able-bodied.” These are the people who would have had to work, volunteer or do training for 80 hours a month to keep medical benefits under the plan proposed by Bevin.

If the court had not struck Kentucky HEALTH — as the state calls the changes — these adults would have only had access to vision and dental coverage through earning dollars in a “My Rewards” account. Now, they’re losing access entirely.

Kentucky Cabinet for Health and Family Services spokesman Doug Hogan wrote in an email that the state made it clear that dental and vision benefits were dependent on the implementation of Kentucky HEALTH. In addition, the benefit reductions, he wrote, are required to compensate for the increasing cost of expanded Medicaid.

“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 place to pay for dental and vision coverage for about 460,000 beneficiaries who have been placed in the Alternative Benefit Plan,” Hogan wrote. “As such, they no longer have access to dental and vision coverage as a result of the court’s ruling.”

On its website, the Kentucky Cabinet for Health and Family Services further laid out its reasons for pulling vision and dental coverage for these enrollees.

“If you received a notice saying you could access vision and dental services through a My Rewards Account, you will not have access to dental and vision benefits,” the state writes. “The legal decision has stopped the ability to use the My Rewards dollars in order to purchase dental and vision services.”

This doesn’t apply to pregnant women, children, individuals who are considered medically frail, former foster youth up to age 26, and groups covered by Medicaid before the expansion. These people will keep their dental and vision coverage.

The court said on Friday in it’s ruling that the state and the federal government had not considered how all the Medicaid changes would impact low-income residents’ ability to get health insurance, as that was the goal of the program written by law.

That ruling struck down the most-controversial part, the “community engagement” requirement that would have meant many enrollees work, volunteer or job train for 80 hours a month in exchange for insurance.

On Friday, Cabinet for Health and Family Services Secretary Adam Meier wrote in a statement that the state will work with the federal agency, the Department for Health and Human Services, to address that single issue: how the waiver might affect health coverage.

“Without prompt implementation of Kentucky HEALTH, we will have no choice but to make significant benefit reductions,” Meier wrote of the new plan in a statement.

State officials have also said they would look at rolling back Medicaid expansion in the state. Hogan wrote in his email that these benefits will be made available again through MyRewards accounts once Kentucky HEALTH moves forward with implementation.