Recently, a federal judge halted implementation of Kentucky’s 1115 Medicaid Waiver, also known as Kentucky HEALTH. Since then, there’s been a fair amount of confusion and questions among Medicaid-eligible recipients, health providers, and advocates.

When it comes to any issue – and that includes Kentucky HEALTH – Kentucky Youth Advocates asks the same essential question, “Is it good for kids?” Read more in our recent statement here.

Conversations continue between the Bevin Administration and the Federal Centers for Medicaid and Medicare Services (CMS) as the Bevin Administration seeks for re-approval of Kentucky HEALTH by CMS before it can be implemented. CMS has opened an additional 30-day public comment period to ensure stakeholders have an opportunity to comment on the entire waiver proposal, issues raised in the litigation, and the court’s decision, and they need to hear from you. View how to submit public comments on Kentucky HEALTH here.

Below, we have outlined how this court ruling may impact children, pregnant women, former foster youth up to age 26, and parents or individuals receiving traditional Medicaid or expanded Medicaid.

Children, Former Foster Youth Up to Age 26, and Pregnant Women

• The 1115 Medicaid Waiver protects children, pregnant women, and former foster youth up to age 26 from the potential negative impacts of premiums or co-payments, reduced benefit packages, and lockout periods.
• This means children, former foster youth up to age 26, and pregnant women should continue to have the same benefits that they had prior to July 1, 2018.

Parents Receiving Traditional Medicaid

• With the federal court ruling, parents at or below 100% FPL (traditional Medicaid) currently do not have to pay monthly premiums or co-payments.
• Parents or individuals receiving traditional Medicaid currently do not have to fulfill any community engagement requirements.
• Additionally, medical, dental, and vision benefits continue as they were prior to July 1, 2018 with no change.
• Parents or individuals with traditional Medicaid can continue to earn dollars for qualifying community engagement, education and training, healthy behaviors, and preventive activities. Click here to view qualifying My Reward activities.

Parents Receiving Expanded Medicaid

• With the federal court ruling, parents between 100% and 138% FPL (expanded Medicaid) currently do not have to pay monthly premiums or co-payments.
• Parents or individuals currently do not have to fulfill any community engagement requirements.
• Medical benefits will continue as they were prior to July 1, 2018 with no change.
• As of July 19, 2018, parents or individuals with expanded Medicaid can continue to access their dental and vision as they were prior to July 1.
• Parents or individuals with expanded Medicaid can continue to earn dollars for qualifying community engagement, education and training, healthy behaviors, and preventive activities. Click here to view qualifying My Reward activities.

Updated resources are available on Kentucky HEALTH website. If you believe you have been incorrectly identified in a different eligibility group, please call 800-635-2570 for assistance to ensure Medicaid-eligible beneficiaries are receiving the services and support they need.