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After Medicaid Ruling Doesn't Go His Way, Kentucky Governor Eliminates Dental and Vision

U.S. Rep. Andy Barr said Monday he supports Kentucky's ability to determine who receives Medicaid benefits, a day after the Bevin administration eliminated access to vision and dental coverage for 460,000 Kentuckians on Medicaid.

By Daniel Desrochers

U.S. Rep. Andy Barr said Monday he supports Kentucky's ability to determine who receives Medicaid benefits, a day after the Bevin administration eliminated access to vision and dental coverage for 460,000 Kentuckians on Medicaid.

"I support federalism and I support each state making those financial decisions for themselves, whether it's Kentucky, Oklahoma or Arizona," the Lexington Republican said when asked if he supports Gov. Matt Bevin's decision. "Each state and states' governors and states' general assemblies and their Medicaid departments have to look at their finances, look at their unique and vulnerable populations and make those decisions on a state-by-state basis."

Bevin, a Republican, chopped vision and dental coverage after a federal judge in Washington D.C. struck down Kentucky's plan on Friday to overhaul Medicaid. The plan would add monthly premiums for many recipients and make "able-bodied" Medicaid recipients work or volunteer in order to receive health benefits. It was slated to start Sunday in Northern Kentucky and extend to most other parts of the state by the end of the year.

Bevin's plan also would have required ongoing verification of extra tasks people must complete in order to win back the vision and dental coverage they previously had as part of their basic coverage.

Doug Hogan, a spokesman for the Kentucky Cabinet for Health and Family Services, said fewer than 10 percent of Medicaid recipients take advantage of their vision and dental benefits each year. He said elimination of the benefits was "required to compensate for the increasing costs of expanded Medicaid."

He did not say how much money the state would save by cutting the benefits.

"This is an unfortunate consequence of the judge's ruling," Hogan said.

Barr, who is facing a strong challenge from Democrat Amy McGrath in Central Kentucky's 6th Congressional District, expressed support Monday for adding work requirements for able-bodied recipients of Medicaid.

"We want people who struggle to find health insurance, particularly if they're self-employed or they're struggling with work, to be able to have that safety net," Barr said. "But we want to encourage people who are unemployed to either work or prepare for work if they're non-elderly, if they're not disabled and they're capable of working."

McGrath was critical of the Bevin administration's decision to eliminate dental and vision coverage for the 460,000 Medicaid recipients who received coverage when former Gov. Steve Beshear expanded Medicaid eligibility under the federal Affordable Care Act.

"Bevin's obvious goal is to take health care away from Kentuckians," McGrath said. "He tried to do it by instituting his unconstitutional work requirements. When that didn't work, he's just going through with taking health care away any way he can."

Barr won his seat in 2012 in part because of his opposition to the health law pushed by then President Barack Obama.

As Republicans gained control of Congress and the White House in 2017, Barr enthusiastically supported Republican efforts to repeal and replace the Affordable Care Act. His stance mobilized many Democrats in the district and contributed to the rise of McGrath, a former Marine fighter pilot. National political forecasters have shifted their rating for the district from "likely Republican" to "toss-up."

Barr was quick to note Monday that the Washington D.C. ruling is not the final word on Kentucky's Medicaid waiver. Bevin counter-sued in federal court in Frankfort the 16 Medicaid recipients who challenged his plan in the D.C. court, setting up the possibility that two federal judges could issue conflicting rulings on the state's Medicaid plan.

"I wouldn't put too much weight in that court decision, it's not a final decision on the merits of the law," Barr said. "I think we have to wait and see what the federal courts ultimately say about this."

Should the Medicaid waiver be struck down by the federal courts, Bevin has promised to end Kentucky's expanded Medicaid program, which would cut health insurance entirely for the more than 400,000 people who lost their vision and dental benefits this week.

(c)2018 the Lexington Herald-Leader (Lexington, Ky.)

Caroline Cournoyer is GOVERNING's senior web editor.
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