A spokesman for the Kentucky Center for Economic Policy says an Affordable Care Act replacement under consideration in the U.S. House of Representatives would be felt in a big way in the commonwealth, but supporters see it as the first step toward state-driven reform.
Dustin Pugel with KCEP, a left-leaning think tank, says the bill would reverse much-celebrated gains in the state’s uninsured rate and cap federal payments for each Medicaid enrollee starting in 2019 – meaning Kentucky would need to make up the difference or drastically reduce benefits.
"It shifts billions in responsibility to the state, making the state responsible for paying more and more, and having a shrinking pot to be able to do that," he warns.
But repeal backers, including Gov. Matt Bevin, welcome reforms they say will hand more control back to the states when it comes to deciding who receives benefits.
"We should be given the ability at the state level to make determinations about work participation, participation in payments, training, etc.," Bevin told WKRC talk radio. "We want to have more control over the Medicaid process."
The comments are in line with provisions in a Medicaid waiver filed by the Bevin administration under President Obama, which included new payment, work, and volunteer requirements for some beneficiaries.
A report released by the nonpartisan Congressional Budget Office Monday predicts 24 million people would lose coverage by 2026 under the new American Health Care Act.