Changes to Kentucky's Medicaid program — including a work requirement — were approved on Friday.

Advocates warned that they would take the state to court in order to block the Medicaid changes.

In response, Governor Matt Bevin filed an executive order that would end the state's Medicaid expansion if a court blocked any part of the changes.

Ending the program could leave up to 480,000 Kentuckians without healthcare coverage.



Kentucky Governor Matt Bevin is threatening to drop nearly 500,000 people from the state's Medicaid rolls if recent changes made to the program are challenged in court.

The federal Department of Health and Human Services (HHS) approved a complex set of change to the state's Medicaid system that would, in part, require all "able-bodied" recipients work or volunteer in order to gain access to coverage.



Activists have said they'll challenge the changes in court, and Bevin issued an executive order on Tuesday that says he will end the state's Medicaid expansion if they succeed in striking down any part of his new rules.

The expansion, part of the Affordable Care Act, gives people making between 101% and 138% of the federal poverty line access to Medicaid. According to the most recent statistics, 480,000 Kentuckians have coverage through the expansion.

The new changes to Medicaid, approved Friday, would require those that are able to work or volunteer at least 20 hours a week in order to gain access to Medicaid. If a person does not meet the work requirement, they could be locked out of gaining coverage for six months. Disabled people, pregnant women, and certain other vulnerable people would not be subject to these requirements.

Opponents of the recent move say that the measure is unnecessarily restrictive and could violate federal law on Medicaid. A number of advocacy groups have threatened to take the issue to court.

Based on the executive action, Bevin is attempting to head off these legal challenges. The new executive would plug the plug on the Medicaid expansion — and nearly half a million people's coverage — if a federal court strikes down any element of the new changes approved by the HHS within six months of the decision.

Bevin long-promised to make serious changes to Kentucky's healthcare system, including shifting the state's Obamacare exchange from a state-based marketplace to the federal Healthcare.gov platform. The Republican originally promised to end the Medicaid expansion if he was elected, but later pivoted and said he would accept changes to the system.