Campaign Action
Gov. Matt Bevin, Kansas’ own "Freedom" maniac, received the first waiver from the Trump administration to impose work requirements on Medicaid recipients. He's also the first governor to be sued over it. Bevin's argument is that it will save the state money because it will force some 100,000 people off of Medicaid in the state. Because he thinks 100,000 more uninsured people is a good thing, apparently. The other problem for Bevin, besides the 100,000 more uninsured people, is that it's going to cost the state more to kick those people off the program than if it did nothing but continue the program as it was.
Cost savings come from the assumption that nearly 100,000 people will drop out of Medicaid by the end of the five-year project recently approved by the federal government. For those who remain, the monthly cost of care increases faster than it would have had the state made no changes, according to the administration's projections.
"You're spending more money to cover fewer people," said Dustin Pugel, a policy analyst for the Kentucky Center for Economic Policy in Berea and a critic of the Bevin plan. "I'm not crazy about the idea of us spending more money to cover fewer people."
Meanwhile, Kentucky plans to spend close to $374 million over the next two years—most of it in federal money—to launch the plan starting July 1.
It has added $186 million to the current budget and proposes $187 million in the next budget year starting July 1 for administrative costs, most of the money associated with the Medicaid changes. Part of the administrative costs added to this year's budget would go toward creating a Medicaid computer system required by the federal government.
Just to make this crystal clear: they are going to spend $374 million to take insurance away from 100,000 people.
Much of the money will go to adding technology to track compliance with new rules that require some people on Medicaid to work, train for jobs or volunteer at least 20 hours a week and pay monthly premiums. Those changes are expected to affect fewer than 200,000 people out of the 1.4 million Kentuckians enrolled in the federal-state health plan.
This is something for other Republican legislatures—like Virginia's—to be honest about while they're considering taking Medicaid expansion now that they can add work requirements to it (until a court rules otherwise, anyway). Is it really about expanding health care in a cost-effective way, or is it about punishing and humiliating any poor people who seek out assistance?