The Capitol building in Frankfort | Photo by Olivia Krauth

The House Democratic Caucus is calling on Kentucky’s health secretary to provide more information about how and why the state removed “key benefits,” such as dental and vision coverage, from thousands of Medicaid recipients.

The letter — signed by all 37 House Democrats — asks Adam Meier, secretary of the Cabinet for Health and Family Services, about the process used to remove the benefits and to inform Medicaid recipients about benefit changes, whether input was sought from members of the General Assembly, and how long it will take to refund premiums.

The July 10 letter also asks about the impact of the lack of dental and vision care on several things, from emergency room use to the opioid epidemic, and speaks of profound uncertainty among “vulnerable citizens.”

“Many of us have received calls, emails and letters from constituents asking questions about what the Cabinet has done, how access to coverage and services has changed, and what the supposed changes to the Medicaid plan mean for their households going forward,” the letter states. ” … We are now presenting you with an opportunity to provide a bit of clarity to perhaps ease the apprehension that is already taking hold among a large number of Kentuckians.”

Congressman John Yarmuth also is seeking answers. He has sent a letter to Alex Azar, secretary of the U.S. Department of Health and Human Services, seeking clarification on what authority Gov. Matt Bevin had to make changes to the state’s Medicaid program.  “Given that the federal government covers 94 percent of all Medicaid expansion costs in Kentucky, the dysfunction Governor Bevin has brought to this critical health care system should be of great concern to you and your agency.”

The flap stems from benefit changes made by the state after a federal judge’s ruling stopped Kentucky’s Section 1115 Medicaid waiver, also known as Kentucky HEALTH, from going into effect July 1.

In response to a lawsuit over the program, the judge decided June 29 that the program should be kicked back to the U.S. Department of Health and Human Services for further review. But instead of keeping benefits as is, the state of Kentucky cut off dental, vision and nonemergency medical transportation.

Rep. Joni Jenkins

“The Cabinet’s decision, as authorized by Governor Bevin, has unnecessarily thrown low-income working families into chaos and confusion,” state Rep. Joni Jenkins said in a news release.

“No one — not recipients, nor providers, nor managed care organizers — knows the rules of Kentucky’s expanded Medicaid program,” Jenkins said. “We want this administration to comply with the court ruling by maintaining the previous level of coverage. Future decisions should be in line with state and federal regulations and timelines and should involve statewide stakeholders.”

The state legislators also raised concerns about reports that children have been denied services, although the state has said that “the Kentucky Department for Medicaid Services (DMS) has not changed any policies relating to the eligibility of pregnant women and children.”

In addition to that issue, the House Democrats want to know more about the timing of the benefit changes involving affected adults.

“Since the court ordered that the status quo of Medicaid be maintained, it is important to learn more about the process the Cabinet used to enact these changes and the justifications for announcing them at this time,” state Rep. McKenzie Cantrell said in the news release.

“It is very important to the families that I serve who are affected by these Medicaid cuts that we receive as much information as possible, because the vision and dental cuts were very unexpected changes that will have significant health impacts on our community,” Cantrell said.

The Kentucky HEALTH program would have included a feature called My Rewards that would have allowed eligible participants to earn virtual dollars to pay for routine dental and vision benefits.

“The court ruling forced the immediate suspension of coverage of some adults dental and vision services by preventing the use of the My Rewards program to pay for them,” the state says on the Kentucky HEALTH website. ” … When the judge stopped the My Rewards program, he stopped these recipients from using the only legal mechanism for those in the alternative benefit plan to pay for the services.”

However, late last week, three justice organizations sent a letter to the federal government challenging the state’s right to make the benefit cuts. The groups — the National Health Law Program, the Kentucky Equal Justice Center and the Southern Poverty Law Center — question whether proper procedure was followed by the state of Kentucky to make the cutbacks and are asking the federal government to take action.

State Representatives Angie Hatton and Chris Harris also have expressed concern about the cuts and held an event in eastern Kentucky Tuesday to call attention to the situation and ask the Bevin administration to reinstate the coverage for the affected low-income residents.

“No one should suffer because of the size of their wallet,” Harris said during remarks in Pikeville.

Darla Carter

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.