On January 24, 2019 another lawsuit was filed in federal district court to challenge CMS’s reapproval of the waiver and on March 27, 2019, the federal district court ruled to block CMS’s reapproval of the waiver. On April 10, 2019, the Trump administration filed a notice of appeal to challenge the federal district court’s ruling. The waiver has not been implemented.
The state submitted its 1115 waiver in August 2016. Subsequently, the state submitted an amendment to the waiver July 3rd, 2017. In 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 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 held an additional 30-day federal comment period from July 19 through August 18 and reapproved the waiver request on November 20, 2018.
- Families USA’s Comments on Kentucky HEALTH Demonstration, reopened comment period (2018)
- 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