Lung Association Is Concerned With Proposed KY Medicaid Changes

LOUISVILLE KY (06/27/2016)(readMedia)-- The American Lung Association in Kentucky is very concerned with Governor Bevin's administration's 1115 waiver to replace the state's current Medicaid expansion program. The proposed program detailed in the waiver would severely limit patients' access to care, including access to quitting smoking.

The plan requires both premiums and work requirements; both are proven significant challenges to low-income individuals. Not only do premiums increase with income level, they would increase based on the length of time an individual has been in the program, with a maximum monthly premium of $37.50 for those making between $11,800 and $15,000 a year (100 and 138 percent of the federal poverty level). Failure to pay a premium could result in enrollees being removed from the program for up to six months.

The proposed high deductible funded account encourages enrollees to choose treatment based on price, not effectiveness. These choices are further incentivized, as enrollees are able to use some of the unused high deductible fund money for over-the-counter medications and gym memberships. The premiums, work requirements and high deductible plan design will limit access care for individuals enrolled in the new Medicaid expansion program.

The American Lung Association is also very concerned about access to preventive services.

The Affordable Care Act (ACA) requires the Medicaid expansion population have access, with no cost-sharing, to all services given an "A" or "B" from the United States Preventive Services Task Force (USPSTF).

Despite tobacco cessation (all 7 FDA- approved medications and all three forms of counseling) receiving an "A" grade, the Waiver only lists phone and online coaching as being covered.

Additionally, the waiver states the new plan benefits will be based on the State Employee Health plan, which currently does not have adequate coverage for tobacco cessation treatment.

The proposal clearly states tobacco use in Kentucky is high and is a driver of poor health outcomes for the state and in fact the state has the highest rates of lung cancer in the country. The state should ensure every smoker in Kentucky has access to a comprehensive benefit.

The Kentucky 1115 waiver, if approved as is, will reduce access to healthcare for low income individuals. It is also unacceptable for Governor Bevin's administration to hold the health of thousands of low-income individuals hostage in his political games- as he said, unless the waiver is adopted, the expansion program will be completely repealed.

Medicaid expansion enrollees deserve access to healthcare. The current program has extremely successful, enrolling over 300,000 people in the first year helping to lower Kentucky's uninsured rate from 20.4 percent to 11.9 percent in the first half of 2014. We urge Kentucky to keep their current, effective Medicaid expansion program, preserving enrollees' access to care.

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About the American Lung Association

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease, through research, education and advocacy. The work of the American Lung Association is focused on four strategic imperatives: to defeat lung cancer; to improve the air we breathe; to reduce the burden of lung disease on individuals and their families; and to eliminate tobacco use and tobacco-related diseases. For more information about the American Lung Association, a holder of the Better Business Bureau Wise Giving Guide Seal, or to support the work it does, call 1-800-LUNGUSA (1-800-586-4872) or visit: Lung.org.