LOUISVILLE, Ky. (July 20, 2016) Kentuckians living at or below the federal poverty level, who often have poorer health to begin with, face more barriers to getting healthier than those who have steady jobs with health benefits, said Susan Zepeda, President and CEO of the Foundation for a Healthy Kentucky, this morning.
“Kentuckians who don’t have paid sick leave, reliable transportation or a bank account already face greater barriers to obtaining and keeping insurance coverage and participating in their own health improvement. Their lost wages and time investment are their ‘skin in the game,’” Zepeda said. “A Medicaid reform plan that creates more barriers will exacerbate the state’s already challenging health statistics and health disparities.”
Zepeda testified on behalf of the Foundation this morning at the Interim Joint Committee on Health and Welfare hearing regarding KentuckyHEALTH, a plan to transform Kentucky’s Medicaid program through a special waiver application to the federal government. She praised several aspects of the waiver proposal: The expansion of substance abuse treatment services, changes to Medicaid Managed Care Organization (MCO) contracts and processes, and healthy behavior incentives. All three garnered broad support from a diverse gathering of stakeholders in a meeting that the Foundation convened in May.
“The waiver is a vehicle for Kentucky to explore new ways of delivering and paying for Medicaid services, moving beyond coverage issues to test innovative ways to deliver care that address access, cost and quality and improve health outcomes,” Zepeda said.
Citing the Foundation’s mission of addressing the unmet health care needs of Kentuckians, Zepeda raised concerns with the proposal, including the loss of dental and vision benefits, monthly premium requirements (especially for those living below the poverty level), lockouts and copayments for failure to pay premiums or enroll on time, mandatory work requirements and loss of non-emergency transportation to and from medical services.
“We should take this opportunity to try evidence-based approaches that advance Medicaid’s purposes, increase coverage for low-income individuals, strengthen provider networks, improve health outcomes and yield sustainable cost savings through increased efficiency and quality of health care,” Zepeda said. “Kentucky can be a national model for cost-effective care delivery in a half-rural, half-urban state.”
To that end, she suggested the state consider approaches that better integrate primary, behavioral and oral health care; harness information technology in new ways; increase price transparency for providers and consumers, such as an all payers claims database; and permit care to be delivered differently, while engaging community partners to help change the social context to support healthier behaviors.
The Foundation’s testimony is available here.
About the Foundation for a Healthy Kentucky
Since the Foundation opened its doors in 2001, it has invested over $26 million in health policy research, advocacy and pilot project grants across the Commonwealth. Funded by an endowment, the mission of the Foundation is to address the unmet health care needs of Kentuckians by informing and influencing health policy, improving access to care, reducing health risks and disparities, and promoting health equity. Follow the Foundation on Twitter and on Facebook, or visit our website at www.healthy-ky.org.
Bonnie J. Hackbarth