“While our rules do not provide for formally extending the federal comment period, as a matter of
practice CMS has generally reviewed and considered all public comments received prior to
rendering a final decision,” Eliot Fishman, director of the state demonstrations group at the Centers for Medicare and Medicaid Services, wrote in a letter dated Oct. 19 to Kentucky Insurance Commissioner Stephen P. Miller.
The changes in Bevin’s proposed Medicaid plan largely target “able bodied adults” who qualify for Medicaid under the expansion of the program to those who earn up to 138 percent of the federal poverty level. The governor’s new plan is designed to encourage participants to have what he calls “skin in the game” through things like monthly premiums, health savings accounts and work and volunteer requirements for those who aren’t primary caregivers. Critics of the plan say it is too complicated and creates barriers to health care.
Bevin has said the current Medicaid plan is unsustainable and that the new plan will save an estimated $2.2 billion over the five-year waiver period, of which the state portion would be $331 million. The federal government is paying the full cost of Medicaid expansion through this year; next year the state will start paying 5 percent, rising in annual steps to the law’s limit of 10 percent in 2020.
Fishman says it will take time to “carefully consider” the “large volume” of public comments. He also added that they are “prepared to continue our dialogue for as long as it takes to find a solution that continues progress for the people of Kentucky.”
In a statement made in response to U.S. Rep. John Yarmuth’s call for the governor to withdraw his proposal since similar request from Arizona and Ohio were rejected, Bevin press secretary Amanda Stamper said that the governor was committed to work with the federal government “as long as it takes to transform Kentucky’s Medicaid program to achieve these vital goals.” Bevin has said that if his plan is not approved, he will not continue the expansion.