In cynical move, Kentucky Governor Bevin cuts vision and dental care to retaliate against court’s Medicaid ruling
Editor’s note: This piece was written by Patrick Willard, Senior Director of State and National Strategic Partnerships at Families USA. It was originally published on Families USA’s blog on July 3. For more information on the Kentucky case, see this post from CLASP. For more information on other states that are seeking to add restrictions to Medicaid, see this page from Families USA. For more on why Medicaid work requirements won’t work, see CHN’s Protecting Basic Needs Programs resource page.
Suppose you wanted to help a homeless veteran find a job, but the vet had some sore teeth and needed glasses. Wouldn’t it make sense to cover the oral health and vision care to help him?
That won’t happen in Kentucky, where state officials abruptly eliminated oral health and vision care for the 460,000 adults who are on the state’s Medicaid program. The decision followed a court ruling a day earlier that struck down a mandate for those on the program to find jobs or lose benefits.
Bevin blaming judge for his action to cut dental and vision coverage
In response to that decision, Gov. Matt Bevin’s administration chose to take away the dental and oral health benefits without any prior notice. It’s as if the governor decided he would just take his ball and go home if the courts would not allow him to play his game of cutting health coverage for Kentuckians.
On June 29, a federal district court found that Bevin’s plan to place restrictions on the health care program was in direct conflict with the primary purpose of Medicaid–to provide people with low incomes, access to medical assistance and coverage. U.S. District Judge James E. Boasberg ruled that the restrictions that federal officials approved for Kentucky were “arbitrary and capricious.”
Bevin wants to blame the judge for the loss of dental and vision coverage. He claims the judge’s ruling meant the benefits could no longer be covered. The administration also says that cutting benefits was “required to compensate for the increasing costs of expanded Medicaid.” In addition, Bevin’s health officials say less than 10 percent of those covered take advantage of the benefits each year.
Governor Bevin’s action will cause immediate harm to Kentuckians
Such twisted reasoning and explanations highlight the hypocrisy of the state’s decision. Oral health and vision benefits have been provided since the state began to cover adults four years ago. In just the first year of expansion coverage, adult dental visits increased 116 percent — a huge help to those who needed care the most in a state where access to dental care and oral health outcomes have been notoriously poor. Those who have needed and benefited from that coverage are also more likely to avoid further health problems in the future. Studies have shown a connection between oral health and overall health, especially related to diabetes and heart disease.
Cutting dental and vision benefits will have an immediate negative impact on Medicaid enrollees who need those services. Kentucky has continually struggled with some of the worst health outcomes in the nation. In 2013, the state ranked 50 in cancer deaths and 45 in premature death. Additionally, Kentucky ranked 41 in annual dental visits and 45 in overall health status. Providing health coverage to adults began to change that outlook in the first years of the Medicaid expansion.
This week’s actions by the governor are the latest in a series since he took office that are aimed at cutting the state Medicaid program. Despite the many indications that the health care law, and Medicaid expansion in particular, were benefiting the people and economy of Kentucky, Bevin is a steadfast opponent. While the federal court decision has created an obstacle to Bevin’s plan to cut Medicaid for now, the case will take months to resolve.
In the meantime, the lives of hundreds of thousands of Kentuckians who rely on Medicaid for needed care hang in the balance.