LWV Medicaid Redesign Statement
Health Committee Report, Oct. 2, 2017
The following is a copy of the statement sent by Bonnie Lynch, President, LWVKY, to the Kentucky Cabinet for Health & Family Services in response to the call for comments re the state’s plan to ask CMS for a #1115 waiver. Granting of the waiver would allow the state to restructure our current Expanded Medicaid program. The text of this letter was released to the media on 08/10/2017.
The League of Women Voters of Kentucky
To:
Vickie Yates Brown Glisson
Secretary, Cabinet for Health & Family Services
Commonwealth of Kentucky
kyhealth@ky.gov
The League of Women Voters of Kentucky (LWVKY) wishes to comment on the state’s plan to redesign our current Medicaid program, including the Expansion, into a system now known as Helping to Engage and Achieve Long Term Health (HEALTH).We are especially concerned that the components of the HEALTH plan—as detailed in the updated and annotated #1115 waiver request to CMS—may not be in keeping with established National and state League positions.
The League of Women Voters of the United States believes that a basic level of quality health care at an affordable cost should be available to all U.S. residents. Other health care policy goals should include the equitable distribution of services, efficient and economical delivery of care, advancement of medical research and technology, and a reasonable total national expenditure level for health care.Statement of Position on Health Care, as Announced by National Board, April 1993 and supplemented by concurrence, June 2016. (http://lwv.org/content/health-care)
At our own State Conference on April 13, 2013, League delegates approved a recommendation that members “monitor the implementation of the Affordable Care Act in Kentucky, insisting on transparency, oversight of contracts, and accountability in order to maintain the focus on the equitable distribution of health services.” Note that, at both the National and state level, League members are concerned about the “equitable distribution of services.”
If the waiver is approved, it is our understanding that the restructured Medicaid/HEALTH program will impose premium and community engagement requirements on persons already doing all they can to cope with insufficient income, transportation problems, and/or few employment opportunities--especially in rural areas. We also question the harsh penalties to be levied on those who fall behind in premium payments or fail to report a change in income within a comparatively short time frame. The “lock-out” periods could impact those with chronic illness, patients who need ongoing treatment or medications.
LWVKY does applaud the recent state initiatives that will tighten regulation of payments to the managed care organizations (MCOs) who direct the delivery of Medicaid services. Such “oversight of contracts” and call for accountability are in keeping with our position.
We urge all who are working on the state’s proposal to protect access to care, to facilitate compliance by eligible enrollees, to keep the "equitable distribution of health services" uppermost in their minds.
Yours respectfully,
Bonnie Lynch
President, League of Women Voters of Kentucky
Hopkinsville, KY 42240