ADEA State Update

Spotlight on Kentucky

(Medicare and Medicaid, Dental Health, Public Health) Permanent link   All Posts

What is a Dental Care Health Professional Shortage Area (HPSA)? The HPSA designation identifies areas and population groups within the United States that are experiencing a shortage of health professionals. Kentucky has approximately 116 dental care HPSAs,[1] but the lack of dental care is most prevalent in Appalachia.

So, why did Governor Matt Bevin (R-KY) suspend dental and vision benefits for nearly 500,000 Medicaid recipients? A single word: Cost.

Governor Bevin stated publicly that to offset the cost of Kentucky’s Medicaid expansion, he has “no choice but to make significant benefit reductions.” The governor’s proclamation follows the June action of a federal judge in Washington, DC, who vacated and remanded Secretary Alex Azar’s approval of Medicaid work requirements and premium increases submitted by Kentucky HEALTH to the Department of Health and Human Services (HHS) for further review.

The plaintiffs, the National Health Law Program and Kentucky Equal Justice Center, sought to block the work requirements from taking effect on July 1 as Governor Benin had planned. In January, Kentucky was the first state to have its 1115 Waiver creating work requirements approved by the Centers for Medicare & Medicaid Services (CMS). Kentucky’s waiver would have required recipients to pay an income-adjusted premium or risk losing coverage for up to six months. Additionally, all able-bodied non-elderly adults would be required to complete 80 hours per month of work, jobs training, education or community service. The 1115 waiver had been created in part by CMS Administrator Seema Verma when she was still a health care consultant.

The state provided no advance notice of the cuts, and now health law advocates say they are considering a legal challenge to the sudden cutoff of dental and vision services. Besides children, pregnant women and adults with disabilities were among those listed as having lost dental coverage. According to the Louisville Courier Journal, many dentists have already had to cancel appointments with Medicaid recipients because they have lost coverage.

For now, Medicaid recipients can still be seen by two ADEA institutional members: the University of Kentucky College of Dentistry and the University of Louisville School of Dentistry. Both dental schools have clinics that treat those who receive Medicaid.  

[1] Bureau of Health Workforce, Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services, Designated Health Professional Shortage Areas Statistics: Designated HPSA Quarterly Summary, as of Dec. 31, 2017.

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