Facebook screenshot of Kristi Putnam, deputy secretary of the Kentucky Cabinet for Health and Family Services

Despite an unfavorable ruling from a judge earlier this summer, the state of Kentucky doesn’t expect there to be a major delay in implementing its Medicaid overhaul known as Kentucky HEALTH, according to a state official.

Kristi Putnam, deputy secretary of the Cabinet for Health and Family Services, gave an update during a stakeholder advisory forum Thursday in Frankfort and took questions about the Section 1115 Medicaid waiver that is under federal review.

The state initially planned to start Kentucky HEALTH on July 1, but U.S. District Judge James Boasberg kicked the program back to the U.S. Department of Health and Human Services for further review June 29 after finding fault with how the waiver was initially approved by the Trump administration.

When asked when the program might start, Putnam said Thursday, “I wish I had a crystal ball, but I do not.”

However, “we don’t anticipate that it will be a significant delay,” she said.

The U.S. Centers for Medicare & Medicaid Services recently opened a 30-day comment period to receive feedback from the public and garnered more than 11,500 online responses from inside and outside the state.

The state is “working with CMS and will provide them with any information they request,” Putnam said. “They have not requested any changes nor have we made any changes to the plan for Kentucky HEALTH, so everything is the same as it was when we received approval before. But CMS has to take the comments into consideration and then provide us with any questions that they have to clarify. We don’t think it’s going to take a long time.”

The program, which includes a work or “community-engagement” requirement, premiums and a My Rewards account, was initially approved in January but a group of Medicaid recipients filed a legal challenge, arguing that the federal approval violated the Social Security Act and Medicaid Act and endangered the health care of tens of thousands of low-income families.

Boasberg ruled June 29 that U.S. Health and Human Services Secretary Alex M. Azar II “never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.”

He also called the approval “arbitrary and capricious” and referred to public input from a previous comment period, noting that commenters had “put the Secretary on notice that the Act might well reduce health coverage for low-income people.”

The New York Times reported last month that Azar continues to favor work requirements.

“We suffered one blow in a district court in litigation,” Azar said. “We are undeterred. We are proceeding forward. We are fully committed to work requirements and community participation requirements in the Medicaid program. We will continue to litigate. We will continue to approve plans.”

But for the moment, Kentuckians don’t have to meet the community-engagement requirement, which was to be slowly phased in across the state, starting July 1, nor do they have to pay premiums, Putnam said. However, anyone who paid their premium early can contact their Managed Care Organization to request a refund or for it to be applied to a future premium.

Putnam recommended that people interested in the community-engagement requirement contact a Kentucky Career Center to find out about opportunities and resources that might be helpful, but the requirement would not go into effect immediately.

“Kentucky HEALTH staff will send a 90-day notice to beneficiaries before the community engagement requirement begins,” she explained.

She also encouraged the public to sign up for the Kentucky HEALTH newsletter and see other updates on the Kentucky HEALTH website.


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Darla Carter
Darla Carter is a hometown girl who recently joined the staff of Insider Louisville to mostly cover health. She previously served as a longtime health and fitness writer for The Courier-Journal, where she also worked for the Metro, Neighborhoods and Features departments. Prior to that, the award-winning journalist wrote for newspapers elsewhere in Kentucky and Tennessee, covering a range of topics, from education to courts. She's a graduate of Western Kentucky University, where she studied journalism and philosophy, and is the proud mom of two young children.