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Governor’s Medcaid reform will reduce costs, add personal responsibility

By JIM WATERS
Bluegrass Institute for Public Policy Solutions

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Sunday, July 3, 2016, 2 p.m. — This Fourth of July would be as good a time as any for all able-bodied Kentuckians to declare their independence … from dependency.

Gov. Bevin’s is trying to help by proposing Kentucky HEALTH, a program designed to inject some personal responsibility and savings – the two usually work in tandem – into the commonwealth’s health-insurance policy.

Many of the one in four Kentuckians who now rely on Frankfort for coverage could pay their own way but are incentivized by the recent Medicaid expansion to be less productive while collecting more benefits.

Such behavior was encouraged by former Gov. Steve Beshear, Bevin’s predecessor, who implemented both the state-run health exchange and the Medicaid expansion by executive orders and without a vote by the legislature – even though taxpayers are on the hook for such programs.

Click here to download the Kentucky HEALTH overview (from the Cabinet for Health & Family Services).

Click here to download the Kentucky HEALTH FAQ (from the Cabinet for Health & Family Services).

Had the expansion been put through the legislative process, the issues of whether it was sustainable and how we could keep it from yanking the chains of government dependency even tighter around the working poor’s necks would have been debated.

There are many good reasons why Bevin is right in moving to get rid of the exchange and reform the state’s Medicaid policy, but they all ultimately crawl back to the original problem: unsustainable costs.

Before the exchange even entered its second year, the largest insurers participating in the exchange requested double-digit premium increases as irresponsible Kentuckians pulled up to the trough and began turning in large claims for chronic health problems ignored for years.

The federal government reneged on its promise to increase funding to address the astronomical costs of this surge.

The feds also promised to continue to pick up a major part of the cost incurred by states, like Kentucky, who expanded Medicaid eligibility.

Why should we believe them? If nothing else, consider HEALTH a contingency plan in case Washington’s check doesn’t arrive.

Now that Bevin’s proposing that adults able to work should do so, or at least be productive in volunteering, going to school or getting job training, you would have thought – based on the opposition – that Chicken Little moved into the governor’s mansion and shoots up on steroids.

But read the plan for yourself at the state’s Cabinet for Health and Family Services website and you will be struck by how similar the HEALTH proposal is to the coverage enjoyed by state workers.

Some current recipients and representatives of social-welfare groups who think little and care less about the cost of government services are whining and sniveling about Bevin’s fairly modest proposal designed to continue the program.

By opposing this plan, opponents stand the chance of losing out altogether as Bevin made it clear: If these reforms aren’t implemented, the Medicaid expansion will be rolled back altogether.

Perish the thought that even low-income individuals might have to accept some responsibility for their own selves by paying small premiums – $15 at the most – to remain in the Kentucky HEALTH plan and receive Medicaid benefits.

Many would pay only about half that amount with – on top of all that – a 60-day grace period before having their accounts suspended.

The response I’ve heard from some hard-working Kentuckians who work extra jobs and sacrifice in other areas in order to afford the hundreds of dollars they pay monthly to cover their families is utter disbelief.

They’re livid at the unfairness of it all.

They pay the health-coverage bills of able-bodied adults who jumped on the merry-go-round of government dependency sped up by Beshear’s Medicaid expansion but now show up at public meetings to squeal about $10 premiums.

Of course, if you’re not working and laying around watching soap opera reruns all day, you can probably pull yourself together long enough to go and protest a policy of personal responsibility in the middle of the day.

Most of us working to pay for their indolence probably won’t be able to make it.

Jim Waters is president of the Bluegrass Institute; Kentucky’s free-market think tank. Reach him at jwaters@freedomkentucky.com. Read previously published columns at www.bipps.org.

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