January 2018: Kentucky received federal approval for its waiver request, with implementation scheduled for July 1. On June 29, a ruling in federal district court vacated that approval, halting implementation. The court sent the waiver request back to CMS for review consistent with the court’s opinion.
The court held that CMS did not “adequately consider whether Kentucky HEALTH [the waiver program] would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.” The court found that HHS/CMS was “arbitrary and capricious” in approving the waiver.
In response to this ruling, CMS has opened a new 30-day federal comment period that runs from July 19 through August 18. The court relied heavily and explicitly on federal comments in its June 29th ruling, and this new comment period is a critical one for the future of Medicaid in Kentucky and nationally. Families USA has developed comment guidance to help advocates frame their input in light of the court decision as they participate in this comment period.
The state submitted its 1115 waiver in August 2016. Subsequently, the state submitted an amendment to the waiver July 3rd, 2017 with the federal comment period open until August 3rd, 2017. The waiver was approved in January 2018, to start July 1. On June 29, 2018, Federal District Court for the District of Columbia vacated CMS’s approval, thus halting implementation (see “Current Status”).
- Families USA Comments on Kentucky HEALTH 1115 Demonstration Modification Request (2017)
- Families USA Comments on Kentucky HEALTH 1115 Waiver Proposal (Federal) (2016)
- Families USA Comments on Kentucky HEALTH 1115 Waiver Proposal (State) (2016)
- View All Federal Comments for 1115 Medicaid Waivers
The Kentucky HEALTH waiver applies to the Medicaid expansion population, as well as most other adults covered by Medicaid. Other populations such as children and other non-disabled adults (like low-income parents, pregnant women and caretakers) are also subject to certain elements of the Kentucky HEALTH waiver.
- Cost-Sharing (ED Copays)
- Work Requirements
- Health Savings Accounts
- Impact on oral health