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CMS Prepares to Review Kentucky Medicaid Proposal

By Marissa Evans, CQ Roll Call

September 8, 2016 -- Kentucky Gov. Matt Bevin's long-awaited proposal to overhaul his state's Medicaid expansion program has been certified as complete by federal officials but it's unclear if they will approve the plan.

On Thursday afternoon, the Centers for Medicare and Medicaid Services certified in a letter that the Bluegrass State has successfully submitted its plan and a 30-day federal comment period now begins.

Marjorie Connolly, press secretary for the Department of Health and Human Services (HHS), said in an email that the agency will "look forward to the people of Kentucky sharing their views and questions with HHS."

Connolly also said that Kentucky's Medicaid expansion as originally structured is working and waiver negotiations can take as long as seven months.

"We are prepared to continue working for as long as it takes to find a solution that builds on the historic progress Kentucky has made under Medicaid expansion and avoids moving backwards," Connolly said.

The state turned in its federal waiver proposal for the so-called Helping to Engage and Achieve Long Term Health, or HEALTH program, on Aug. 24. Kentucky used the summer to hear public comments about the plan to give a major makeover to the Medicaid expansion proposal, which had been touted nationwide for its enrollment growth.

Bevin's plan calls for conservative wish list items such as work requirements, lock-out periods, health savings accounts, and nominal premium payments. Advocates and lawmakers are now waiting to see if Bevin will follow through on scrapping the program altogether if HHS does not approve his plan.

Under an executive order in 2014, Kentucky expanded eligibility for the joint federal-state health insurance program for the poor and disabled. The federal health law allows states to expand Medicaid to individuals with incomes up to 138 percent of the poverty level. Starting in 2017, states will have to start chipping in 5 percent of the costs and by 2020, 10 percent of costs. Thirty-one states and the District of Columbia have taken up expansion.

Bevin vowed on the campaign trail last year to make changes to the Medicaid program. While he was steadfast in dismantling Kynect, the state's health exchange website, he has pivoted in recent months when it comes to Medicaid expansion. While he initially called for dropping the 400,000 low-income Kentuckians who qualified, he has since walked back the idea and said his administration would craft a more efficient plan to potentially continue the program while saving costs.

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