By skyforbes 
The Urban Institute did a fine job of crunching Census numbers to explain who’s at risk as Kentucky seeks to become the first state to require Medicaid recipients to work or volunteer at least 20 hours per week.
First, a couple of helpful charts from Urban’s report:
Let’s break it down. There are nearly 169,000 people who are already working and receiving Medicaid healthcare benefits, but it’s unclear whether they’re working enough, and can document the work correctly in order to continue to receive Medicaid healthcare coverage, according to Urban.
Assuming they can do those things, there’s one group of Kentuckians who stick out as most likely to lose coverage. As Genevieve Kenney, one of the report’s authors, put it in an email:
Among the three enrollee groups we examined, we anticipate that those who are potentially non-exempt and not working are most at risk of losing Medicaid coverage.
Of those on Medicaid who aren’t working — approximately 188,000 people — nearly half are above age 50, have low income and education and report serious health problems, “characteristics which make it hard to fulfill the waiver’s work/community engagement requirements as well as to document compliance,” Kenney wrote. Not to mention plenty don’t have a car, access to reliable transportation or an Internet connection.
I can see where Kentucky Gov. Matt Bevin’s math is coming from. As the Christian Science Monitor pointed out, Bevin’s administration says around 95,000 would be cut from the Medicaid rolls as a result of the changes. Bevin has touted the benefits of the decency of work as a driver of this change — but also said that the Medicaid program is simply financially unsustainable.
Governing Magazine also points out:
There is more in Kentucky’s waiver than just work requirements. The state also received approval to lock people out of coverage for six months if they fail to take a health or financial literacy course, report a change in income or pay premiums. The lawsuit argues all of these are illegal under the Medicaid statute.
But here’s a wrench to keep in mind: there could be serious changes on the way if a pending lawsuit is successful. The National Health Law Center and others who have sued say the state’s so-called “waiver” — the ability for Kentucky to implements its own requirements for Medicaid, granted by federal health officials under President Trump — has nothing to do with healthcare. (If the lawsuit is successful, Bevin says he’ll do away with Medicaid expansion altogether.)
“Waivers are supposed to be experimental,” Leanardo Cuello, of the NHLC, told Governing. When you knowingly take away health benefits, “what is the experiment? What are you testing?”
As journalist Sarah Kelley wrote for us last year, Kentucky picked up 460,000 Medicaid recipients when it expanded the program under the Affordable Care Act in 2014.
Kentucky’s new work requirements are scheduled to go into effect in July. It’s why Peachill and Insider Louisville are partnering to crowdfund a story to make sure we’re on top of this in and around Louisville. Give as little as $1 to support the campaign today!
Jeremy Borden is the editor and journalism director at Peachill Publishing, which seeks to build communities around story ideas from idea to distribution.