Ky. GOP cuts vision, dental care for 460K

Published 11:29 am Tuesday, July 3, 2018

LOUISVILLE, Ky. (AP) — Gov. Matt Bevin’s administration cut dental and vision coverage for as many as 460,000 Kentuckians after his Medicaid overhaul plan was rejected in court.

The state Cabinet for Health and Family Services called the cuts an “unfortunate consequence” of Friday’s ruling by a federal judge. Democrats and advocates for the poor condemned the Republican governor’s move as rash and possibly illegal. The cuts were announced during the weekend.

U.S. District Judge James E. Boasberg’s rejection of Bevin’s plan to overhaul the state’s Medicaid program was also a setback for President Donald Trump’s administration, which has been encouraging states to impose work requirements and other changes on the joint state and federal health insurance program for poor and disabled people. Boasberg’s ruling blocks those requirements for now in Kentucky.

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Bevin’s administration squarely blamed the judge for the cuts, saying his ruling removed a “legal mechanism” to pay for dental and vision coverage for about 460,000 Medicaid beneficiaries and left officials with less than two days to undo a year and a half of planning.

“As such, they no longer have access to dental and vision coverage as a result of the court’s ruling,” the cabinet said.

Bevin spokeswoman Elizabeth Kuhn said the Medicaid changes had offered “a sustainable path” to provide the dental and vision benefits, but said the judge’s ruling means there’s “no longer a viable method” to provide the services.

The state’s health and family services cabinet on Monday said Bevin’s administration is “working through the impacts.”

“We hope that we can work together to quickly resolve the fallout from the court ruling” so the benefits program can be reinstated, it said.

Democratic state Rep. Joni Jenkins said she’s concerned about “rash decisions” in response to the ruling.

“We call for thoughtful discussions involving the administration and the many statewide stakeholders in the path forward in assuring Kentucky’s working families have health care,” Jenkins said.

Jenkins said the Bevin administration’s “short-sighted” actions are already causing confusion and hardships.

“We have folks that are showing up for dental appointments that they made months ago and neither they nor the providers are really certain what the rules are,” she said. “And that’s just unacceptable for government to be operating this way.”

Sheila Schuster, a longtime Kentucky advocate for the disabled and people without health coverage, said the cuts were “totally uncalled for,” and could spark another legal fight.

“The real question is: Are they within their legal authority to suspend benefits that are part of this program and are part of the essential health benefits without any due notice and without any hearings?” she said. “I think that’s a question to be resolved in the courts.”

Bevin’s action could also worsen the state’s drug addiction problems, administration critics said.

“We know that untreated dental pain is a huge gateway to addiction to painkillers,” Jenkins said.

The federal health care law championed by former President Barack Obama gave states the option of expanding Medicaid coverage to able-bodied adults. Kentucky, under former Democratic Gov. Steve Beshear, was one of 32 states that did so, and nearly 500,000 Kentuckians got Medicaid coverage as a result.

But Bevin, elected in 2015, said the program was too expensive to continue. He sought permission to impose new rules, including charging monthly premiums and requiring at least 80 hours of “community engagement” per month, which could include working, volunteering or going to school.

Adam Meier, Bevin’s secretary of the Cabinet for Health and Family Services, has said if the ruling stands, the state would have “no choice but to make significant benefit reductions.” He said Kentucky faces a $300 million shortfall in Medicaid over the next two years, and the new rules would have helped the state save money.

Kentucky was the first state to get permission to impose new rules, which were scheduled to take effect Sunday in a northern Kentucky suburb of Cincinnati.

In his ruling, the judge chastised Trump’s administration for rubber-stamping the new rules without considering how many people would lose their health coverage.

The cabinet said the state “made it clear” that dental and vision benefits for the approximately 460,000 beneficiaries were dependent on the new Medicaid changes. It also said only small percentages of Medicaid recipients have taken advantage of routine vision and dental coverage in the past.