The CMS is taking the unusual step of extending the comment period on a proposal to change Kentucky's Medicaid program to include controversial provisions such as job requirements, cost-sharing and six-month lockouts for missed payments.
The agency has received nearly 1,800 comments on the waiver. In comparison, Ohio's recent request generated 103 comments, while Arizona's drew 98 comments.
The comments have offered mixed reactions to Republican Gov. Matt Bevin's waiver, and some asked the agency to allow for more time for others to comment past the Oct. 8 deadline.
Eliot Fishman, director of the state demonstrations group at the CMS, said in a letter Wednesday that while the rules did not provide for a formal extension, the agency would consider comments submitted after the official comment period ends. There was no indication for how long, though.
Federal records show Kentucky is the first state to receive such an extension.
Kentucky officials had no comment on the decision.
“There is no doubt Kentucky's request will be denied,” Yarmuth said Tuesday. The CMS has never approved a waiver that mandates job requirements or volunteering.
The waiver, first submitted in August, has been largely criticized by advocates who say the proposed changes will harm access to care if approved.
The 1115 waiver titled Kentucky Health would require able-bodied adults without dependents to participate in job training or community engagement such as volunteer work. The five-year program also would require monthly premiums ranging from $1 to $15 and includes two health savings accounts. One is for the $1,000 deductible, and the other is a rewards account that could be used for dental and vision services as well as some over-the-counter medicines and gym memberships.
Those who are above the poverty level and miss two months of payments would be locked out of the program for six months. Those below the poverty level would be required to pay copays and would have their rewards accounts suspended after 60 days of nonpayment.
Bevin's administration claims the current Medicaid expansion, which was implemented by his Democratic predecessor, Steve Beshear, is unsustainable and is not resulting in better health outcomes. Bevin estimates a savings of $2.2 billion over the five-year waiver period. An estimated 1.2 million people would be moved into the Kentucky Health program.