FRANKFORT (AP) — Kentucky’s Medicaid program is facing a $125 million deficit this year and a $611 million deficit over the next two years as it struggles to keep up with an aging population, a flood of new enrollees and the end of 100 percent federal funding for its expanded eligibility requirements.
Kentucky Health and Family Services Cabinet Secretary Vickie Yates Brown Glisson told House budget writers Wednesday the problem is so bad she worries about the sustainability of the program that provides health insurance for more than a quarter of Kentucky’s population.
“Traditional Medicaid is hemorrhaging. It’s not bleeding, it’s hemorrhaging,” Glisson said. “I think that was one of the most stunning and appalling things I found out when I first came to the Cabinet.”
But Glisson could not tell lawmakers how she planned to make up the deficit. She promised to have details next week. That frustrated some state representatives, who are scheduled to vote on the budget proposal next week. She promised not to cut benefits, programs or employees. But Democratic state Rep. Jim Wayne of Louisville was skeptical.
“It’s hard for me to say at this time that I trust you,” Wayne told Glisson. “You continue to blame the previous administration. (Republican Governor Matt Bevin) bought this job with his $3.5 million. I think it’s time for the blaming to stop.”
Wayne was referring to the money Bevin, an investment manager, donated to his campaigns for governor. Republican state Rep. Addia Wuchner of Florence, one of the few Republicans who attended the meeting, angrily walked out during Wayne’s comments. As she was leaving, she told Glisson: “This is not a campaign any longer. It’s about issues.”
Kentucky’s Medicaid program will be a political battleground for years to come. When former Democratic Gov. Steve Beshear chose to expand Medicaid, it brought in more than 420,000 additional people and took Kentucky’s uninsured rate from 20.5 percent to 7.5 percent, tied for the largest coverage gain in the nation.
But the program also brought in more than 60,000 people who were already eligible for Medicaid. Those people were added to the traditional program, where Kentucky taxpayers must pay 30 percent of the cost. They cost the state $124 million, money Glisson said the previous administration had not planned to spend. And beginning next year the federal government will stop paying 100 percent of the costs for the 420,000 people who were added to the program. That will cost Kentucky taxpayers $257 million.
Bevin wants to repeal Beshear’s Medicaid expansion and replace it with something else. He needs permission from the federal government do to that. On Monday, he met with U.S. Health and Human Services Secretary Sylvia Burwell in Washington, a meeting Bevin’s spokeswoman called “a constructive discussion.”
Glisson said to weather the shortfalls, the Beshear administration cut the Department of Community Based Services — which oversees the state foster care and adoption systems and investigates allegations of child abuse — by $13 million last year and $42 million the year before that.
“I worry about that because … lives are at stake,” Glisson said.
Former Health and Family Services Cabinet Secretary Audrey Haynes, Glisson’s predecessor, said from 2012 to 2014 it was the Medicaid budget that had to bail out the Department of Community Based Services. Over the last two years, community-based services paid Medicaid back.
“The new secretary has that ability, too,” Haynes said. “She will appreciate that ability for one agency to help out the other so people are not hurt or minimized.”