Call to Order and Roll Call
The fourth meeting of the Budget Review Subcommittee on Human Resources of the Interim Joint Committee on Appropriations and Revenue was held on<Day> Thursday, October 27, 2016, at 10:00 AM, in Room 169 of the Capitol Annex. Representative Joni L. Jenkins, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Representative Joni L. Jenkins, Co-Chair; Senator Carroll Gibson; Representatives Tom Burch, Mary Lou Marzian, Jim Wayne, and Addia Wuchner.
Guests: Stephen Miller, Commissioner, Department for Medicaid Services, Cabinet for Health and Family Services; Jill Hunter, Deputy Commissioner, Department for Medicaid Services, Cabinet for Health and Family Services; Betsy Johnson, President, Kentucky Association of Health Care Facilities; Terry Skaggs, Chief Financial Officer, Wells Health Systems; Jason Bailey, Executive Director, Kentucky Center for Economic Policy; Emily Beauregard, Executive Director, Kentucky Voices for Health; Adam Meier, Deputy Chief of Staff for Policy, Office of the Governor; John Watkins, Deputy Executive Director, Kentucky Office of Health Benefit and Information Exchange, Cabinet for Health and Family Services; and Representative Derrick Graham.
LRC Staff: Miriam Fordham, Jonathan Eakin, and Amie Elam.
Transition to Federal Health Benefit Exchange
Adam Meier, Deputy Chief of Staff for Policy, Office of the Governor, provided an update on the transition to the Federal Health Benefit Exchange. Mr. Meier included information regarding completed milestones, websites, education and outreach, and a budget projection update.
In response to questions from Senator Gibson, Mr. Meier said that the premium differences between the remaining carriers are based on actuarial presumptions made by each carrier. The remaining carriers are reacting to the market when setting premiums. United Health, Baptist Health, Aetna, and Wellcare left the exchange market this year. The companies are making business decisions based on federal government policies. He said there is little that could be done at the state level to incentivize companies to stay.
In response to questions from Representative Wayne, Mr. Meier said that the Governor's administration renewed the contract with the same kynector agencies. The kynectors had some different training and certification requirements. The advertising contract was not canceled, but it expired. Funds for advertising were federal dollars provided for the rollout. Advertising funds went from $6-$7 million to $200,000. Mr. Meier said that he would provide to the committee information regarding the average premium increase and the average tax credit.
In response to a question from Representative Wuchner, Mr. Meier said plan options are on the Department of Insurance's website. In-Person Assisters (IPAs) will be tasked with educating consumers on what each plan does and the costs associated.
In response to questions from Chair Jenkins, Mr. Meier said that healthcare.gov has a 24-hour call center.
Medicaid Re-Enrollment
Stephen Miller, Commissioner, Department for Medicaid Services, provided an update on Medicaid re-enrollment. Mr. Miller discussed the 90-day window that enrollees have to change Managed Care Organizations (MCOs).
In response to a question from Chair Jenkins, Mr. Miller said that Medicaid has a passive enrollment. If users take no action, then they remain with the same MCO.
Medicaid Issues Facing Kentucky's Long-Term Care Community
Betsy Johnson, President, Kentucky Association of Health Care Facilities (KACHF), and Terry Skaggs, Chief Financial Officer, Wells Health Systems, testified on the pending Medicaid issues that are facing Kentucky's long-term care community. The presentation included KACHF's proposal to alleviate Medicaid pending issues and a proposal for providing advance payments to providers.
In response to a question from Representative Wayne, Mr. Skaggs said that in 2014, families lost the ability to go to local Department for Community Based Services (DCBS) offices to make a Medicaid application. Staff is working on the backlog of applications, and there is significant progress being made. Commissioner Miller said that much time and effort has gone into trying to correct the backlog issues. He stated that many families never responded to the cabinet's requests for information (RFIs). There is no provision for issuing interim payment. The cabinet believes a better and faster solution is to fix the system and get rid of the backlog rather than issue interim payments that may not be approved by CMS.
Medicaid Section 1115 Waiver Proposal
Jason Bailey, Executive Director, Kentucky Center for Economic Policy, and Emily Beauregard, Executive Director, Kentucky Voices for Health, discussed issues surrounding the Medicaid Section 1115 Waiver Proposal. Mr. Bailey discussed Medicaid expansion. Ms. Beauregard discussed Medicaid changes under the current administration and the impact on enrollees.
In response to a question from Representative Wuchner, Ms. Beauregard said that enrollment assisters have done a great job helping consumers navigate the system and educating them on how to use their benefits.
In response to questions from Chair Jenkins, Mr. Bailey said that Kentucky's hospital provider tax is frozen and does not keep up with revenue growth rates. Mr. Bailey added that other states have increased the provider tax while in Kentucky the provider tax is decreasing.
There being no further business before the subcommittee, the meeting was adjourned at 11:54 a.m.