Kentucky is currently negotiating a Medicaid overhaul with the federal government that includes monthly premiums, work requirements and a rewards program that requires "able-bodied" adults to earn vision and dental coverage, according to a report from the Courier-Journal.
Kentucky Gov. Matt Bevin, R, and his administration proposed the overhaul to help control costs and expect greater responsibility among enrollees, according to the report. The plan would charge enrollees premiums ranging from $1 to $37.50 per month. The rate would depend on income and time enrolled in Medicaid — premiums would increase with time to incentivize people to get out of the program, according to the report. It also includes provisions that would add copayments and a mandatory work or volunteer requirement for coverage.
The proposal would strike dental and vision coverage from Medicaid for "able-bodied adults — pregnant women not included — and replace it with a rewards program. This requires enrollees to earn points, which can be used toward dental and vision services. Points can be earned by passing the GED exam, completing job training or completing a wellness activity. Points can also be lost if enrollees miss a premium payment or use the emergency department inappropriately, according to the report. Enrollees can also be "locked out" of coverage for up to six months if they miss a payment.
Critics are concerned because the Medicaid expansion passed in 2014 proved to be successful, according to the report. They believe the costs associated with getting the proper technology and staff up and running to track the various elements of the new plan would be costly. However, the Bevin administration plans to delegate the work to the same companies that currently oversee the program, according to the report.
Approval is expected by June, and if the program is approved, it would go into effect in January 2018, according to the report.
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