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Yahoo
02-04-2025
- Health
- Yahoo
GOP changes to Medicaid in doubt after Democrat Beshear says legislature failed to fund them
Gov. Andy Beshear appeared before a joint session of the House and Senate on Jan. 8, 2025 to deliver his State of the Commonwealth address. (Kentucky Lantern photo by Arden Barnes) This article mentions suicide. The number for the National Suicide Prevention Lifeline is 988. Changes the Kentucky General Assembly ordered in Medicaid face an uncertain future after Gov. Andy Beshear said lawmakers failed to fund the legislation. For the second year in a row, Beshear last week sent the House and Senate a letter listing bills that they had passed without providing what Beshear said was the necessary funding. Beshear sent the letter on the next to last day of the 2025 session, listing 11 bills and writing 'there is still time in this legislative session to add appropriations.' The Republican-controlled legislature took no action in response to the Democratic governor's letter, and Senate President Robert Stivers, R-Manchester, told reporters Beshear is obligated to carry out laws as enacted by the legislature. 'He wants to make some excuse about, 'oh, you didn't give me the money.' But it's basically: 'yes, you do have the money. Find it within your budgets,'' Stivers said. Among the 11 bills that Beshear said lack 'the appropriations necessary to implement' them is House Bill 695, which directs the Beshear administration to take steps to enact a Medicaid work requirement while prohibiting the administration from making any changes in the $15 billion program without first receiving the legislature's approval. The bill also creates a Medicaid Oversight and Advisory Board to look for cost savings in Medicaid. Beshear vetoed the bill and the legislature easily overrode his veto. The clash comes as Democrats in Washington are bracing to fight Republican efforts in Congress to cut Medicaid — a federal-state program that covers health care for low-income people — in order to pay for renewing federal tax cuts. In the letter, Beshear said HB 695 would require rebidding Medicaid managed care contracts, which he said would cost the state $1.4 million, including hiring a contractor to help develop the request for proposal. The bill also is estimated to cost $500,000 in state funds to conduct a managed care long-term service study, Beshear wrote. In his veto of HB 695, Beshear said the Medicaid community engagement requirement, commonly called a work requirement, would 'undoubtedly' cost some adults their health coverage and also spark costly litigation challenging the requirement. Emily Beauregard, the executive director of Kentucky Voices for Health, said health care advocates are concerned about new costs associated with a work requirement. 'One of our concerns all along with HB 695 has been the additional administrative cost it requires to ultimately provide less health care, which isn't a good use of taxpayer dollars,' she said. Beshear's letter to lawmakers last week echoed one he sent the year before, which has sparked a lingering controversy over the state's failure to fund relief for kinship care families. Lawmakers have previously said Beshear has misinterpreted a 2005 state Supreme Court decision that he says precludes the executive branch from spending money the legislature has not appropriated. That decision came out of a cycle when the General Assembly passed no budget. Still, Beshear wrote: 'These holdings are simple: if the legislature creates a policy or program but does not provide funding, it does not intend for the executive branch to perform those services over the biennium. The omission of an appropriation is the same as its elimination.' Beshear also cited a more recent federal court decision. On Friday, Stivers criticized Beshear's handling of the kinship care issue, which resulted in months of back and forth with no solution for families who are raising minor relatives and need more assistance. 'He decided to expand Medicaid rolls, not do kinship care, but then he says he doesn't have the money to do it,' Stivers said. 'He picks and chooses what he wants to do, even though we've told him what to do.' 'We've talked about on this floor all the things he decided to fund without authority, things he does without authority. We send him bills, and it's his obligation to carry out those laws that we change and empower him to execute on,' Stivers said. Most of the funding for Medicaid comes from the federal government. Beshear said 1.6 million Kentuckians are covered by Medicaid and the Children's Health Insurance Program. Beshear's letter to lawmakers also said they had failed to take into account the costs of their decision to protect conversion therapy. House Bill 495 overrules restrictions Beshear had placed on the discredited practice and also prohibits Medicaid from covering transgender-affirming medical care. Beshear estimated it would cost $540,000 to $1.95 million in state funds. 'Flabbergasted:' Help for kinship care families passed unanimously. $20M price tag could derail it. 'Other states with similar laws have experienced an increase in suicide attempts, some by as much as 72%,' Beshear wrote. 'The increase in services expected include an additional six hours of behavioral health counseling and therapy, an increase in pharmacy costs and increased psychiatric hospitalization.' Among other bills Beshear said the legislature failed to fund: Senate Bill 4, which he said would cost at least an estimated $2.5 million to operate a centralized registry of artificial intelligence systems in state government and implement an AI governance process. House Bill 390 to set up an accessible online vehicle insurance verification system, which Beshear said would cost $600,000 to $1.1 million initially and then $750,000 a year to operate. Beshear also said that House Bill 346, exempting emergency temporary internal combustion engines from paying an emissions assessment fee and to retroactively refund some fees would cost the Division of Air Quality $1 million in expected revenue from fees. FILE_4515 (1)
Yahoo
28-03-2025
- Politics
- Yahoo
Kentucky lawmakers override most vetoes by Gov. Andy Beshear
FRANKFORT, Ky. (FOX 56) — Lawmakers returned to Frankfort Thursday for the last two days of the 2025 Regular Session of the General Assembly. However, the day was spent not necessarily making new policy but overriding the executive opposition to it. 'Veto of the governor notwithstanding' was a phrase that was heard many times on Thursday. It's a routine all too familiar to the current General Assembly. The first day back from the veto recess is typically spent overturning most if not all the vetoes just decided in the past 10 calendar days, excluding Sundays, by Gov. Andy Beshear. Thursday was no exception, with override votes held throughout much of the day, with both chambers later concurring on those votes. 'So, this is a bill that will do damage to thousands of people in my district and overturning the veto is a terrible idea,' Rep. Adrielle Camuel said against HB 695, a Medicaid reform bill that could also introduce work reporting requirements. Kentucky lawmakers override most vetoes by Gov. Andy Beshear Gov. Beshear veto against tolls on new I-69 bridge overriden Here's how to watch the Wildcats play against Tennessee on a giant screen for free Democrats spoke frequently to offer a last word against the overrides. The Republican majority took a different tone, rarely commenting on the vetoes being overridden. However, House floor leader Rep. Steven Rudy (R-Paducah) could be seen tossing veto messages in the trash as votes were being taken, which Kentucky Republicans lauded on social media. Beshear vetoed 29 pieces of legislation, five of which were line items. At Thursday's Team Kentucky, he said he was pleased with early bills like House Bill 1, which will cut the state income tax next year, but he criticized how committee substitutes were used in some instances to speed along bills with little public input. 'By the end of the session, it turned into nasty bills that make people feel unwelcome,' Beshear said. Beshear pointed to bills like House Bill 495, a bill rolling back last year's executive order banning conversion therapy, something Republicans have argued was an overstep in authority. A Senate substitute now also ends coverage for transgender care through Medicaid. A visibility rally was held ahead of the vote overturning the veto. Gov. Beshear vetoes 9 bills on education, healthcare, and more on Wednesday 'I found myself comforting friends and neighbors who are going to lose access to the medicine that keeps them alive. I found myself comforting trans Kentuckians and their families who love this Commonwealth but have been consistently told by this extremist super majority that their Commonwealth does not love them back,' LFUCG Councilmember Emma Curtis, a transgender Kentuckian, said at the rally. 'I wish the Governor would take note of that, that he overreached his boundaries in terms of setting policy, where this body has the obligation and the responsibility of doing that,' Rep. Ken Fleming (R-Louisville) said later that afternoon when lawmakers voted to override the veto of HB 495. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
11-03-2025
- Health
- Yahoo
Legislators seek to examine Kentucky Medicaid for ways to contain costs
Rep. Adam Bowling, R-Middlesboro, presents legislation aimed at containing Medicaid costs in Kentucky, which he told the House are "just not sustainable," March 4, 2025. (LRC Public Information) FRANKFORT — Medicaid — the federal-state program that provides health care to almost 1.5 million Kentuckians — is on the chopping block in Washington and could soon come under examination in Frankfort. The House has approved creating a 21-member Medicaid Oversight and Advisory Board to look for ways to rein in Kentucky Medicaid cost increases. Meanwhile, the Beshear administration would be barred from making any changes to Medicaid eligibility, coverage or benefits in Kentucky without first getting a green light from the General Assembly unless the changes are required by federal law. The House also voted to reinstate prior authorization requirements for Medicaid behavioral health benefits which include treatment for substance use disorder. Rep. Adam Bowling, R-Middlesboro, the sponsor of House Bill 695, said the legislation is necessary because of unsustainable growth in Medicaid's cost. 'Roughly one out of three Kentuckians is currently enrolled in Medicaid. … It's the second largest general fund unit within our state budget. And the growth we are seeing currently is at a rate … it's just not sustainable,' Bowling said. 'So all we are trying to do with House Bill 695 is just stabilize the program, hold it where it is today.' The House approved HB 695 by an 80-19 party line vote on March 4 while Bowling's House Bill 9 creating the oversight board was approved 99-0. Democrats opposed the requirement for prior authorizations to receive mental health care. Rep. Lindsey Burke, D-Lexington, called it a 'bridge too far.' HB 695 gives the Cabinet for Health and Family Services 90 days after the bill becomes law to 'reinstate all prior authorization requirements for behavioral health services in the Medicaid program that were in place and required' on Jan. 1, 2020. During the House debate, Burke said, 'When someone has made the brave and courageous decision to come to seek mental health treatment, they are often in a position where they need immediate service. And it troubles me to think that we've asked someone who has made that courageous decision to wait and see if their insurance will cover it. Our citizens are already experiencing a mental health epidemic, and we know that prior authorization slows down essential treatment for Kentuckians.' Emily Beauregard, the executive director for Kentucky Voices for Health, opposed the prior authorization requirement during a Feb. 25 committee meeting, saying quick access to mental health care can avert costlier medical crises. 'We know from years of experience that prior authorizations can delay access to behavioral health services for individuals facing an acute need and for conditions like depression, anxiety and substance use disorder, early intervention is crucial to improving health outcomes and reducing the need for higher cost services such as emergency room visits or inpatient hospitalization.' she said. However a group of independent treatment providers supports the reinstatement of prior authorizations, saying they will help ensure that available funds go to help those most in need. John Wilson, president of the Kentucky Association of Independent Recovery Organizations, told the Lantern that 'bad actors' during the COVID-19 pandemic 'exploited the system.' That, he said, led to 'unnecessary services and payments – with little to no respect given to patient care or outcomes.' 'We recognize the additional burden prior authorizations bring to providers, but this important tool to control waste, fraud and abuse has already been reinstituted in other areas of health care,' Wilson said. 'KAIROS believes that reinstituting prior authorizations will ensure that the available funds are spent on those who need it most. In fact, many KAIROS members did not change their own policies and procedures regarding prior authorizations during the suspension and continued to function as though authorizations were still required.' Kentucky Medicaid already has restored some mental prior authorization requirements which were suspended during the COVID-19 pandemic. Kendra Steele, a spokeswoman for the Cabinet for Health and Family Services, said 'changes were made to specific services and additional changes are on track to be implemented in the near future' following the COVID-induced pause for those prior authorizations. 'When the policy is reinstated, (the Department for Medicaid Services) will work to ensure Medicaid members continue to receive the appropriate level of care needed in a timely manner,' Steele said, adding that the state 'is committed to ensuring health care access for Kentuckians, including access to behavioral health services, counseling and treatment for addiction.' During the Feb. 25 meeting, Rep. Jason Petrie, chairman of the House budget committee, likened HB 695 to a 'type of triage to put a stasis on the program so that it doesn't grow uncontrollably, ineffectively and inefficiently in the very, very short term, until the Medicaid Oversight Advisory Board can get on its feet and start making better make informed policy decisions, along with executive branch and participants in this big program.' The advisory board would be made up of 10 lawmakers (five from the Senate and five from the House) and 11 non lawmakers including the state's chief medical officer, the state auditor, the chair of the Advisory Council for Medical Assistance and others. Its job would be to 'review, analyze, study, evaluate, provide legislative oversight, and make recommendations to the General Assembly regarding any aspect of the Kentucky Medicaid program.' Bowling told the committee that HB 9 is 'a good way to get the executive branch, the legislative branch and then stakeholders as well, all at the table, to be able to go through all these issues that have come up surrounding Medicaid.' Bowling pointed out the legislature must 'figure out how to piece the funding' for Medicaid changes made by the administration. 'We want to come together with the executive branch to make sure we have a better idea and we can make more educated decisions about which changes we want to implement and which changes are not in Kentucky's best interest, as we see it,' he said. Medicaid in Kentucky costs taxpayers about $15 billion a year. Most of that money — 70% to 90% — comes from the federal government. Medicaid pays for medical and nursing home care for low income people and people who have disabilities, including 4 in 9 Kentucky children, according to KFF, a nonprofit research organization focused on health care. In Washington, Rep. Brett Guthrie of Kentucky is chairman of a U.S. House committee that's looking for ways to cut $880 billion from the federal budget to pay for extending tax cuts enacted in 2017 — a task that is considered impossible without cutting Medicaid which costs the federal government more than $600 billion a year. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
01-03-2025
- Politics
- Yahoo
Advocates push for improved family benefits as key bills stall
VICTORIA BUDIONO / VBUDIONO @ Advocates rallied Friday in support of improved benefits for Hawaii's keiki. 1 /2 VICTORIA BUDIONO / VBUDIONO @ Advocates rallied Friday in support of improved benefits for Hawaii's keiki. VICTORIA BUDIONO / VBUDIONO @ State Sens. Kurt Fevella (R, Ewa Beach-Ocean Pointe-Iroquois Point ), left, and Sharon Moriwaki (D, Waikiki-Ala Moana-Kakaako ) advocated Friday for bills that promote economic security and equity for children, affordable child care programs, preschool and other causes at the state Capitol rotunda. 2 /2 VICTORIA BUDIONO / VBUDIONO @ State Sens. Kurt Fevella (R, Ewa Beach-Ocean Pointe-Iroquois Point ), left, and Sharon Moriwaki (D, Waikiki-Ala Moana-Kakaako ) advocated Friday for bills that promote economic security and equity for children, affordable child care programs, preschool and other causes at the state Capitol rotunda. VICTORIA BUDIONO / VBUDIONO @ Advocates rallied Friday in support of improved benefits for Hawaii's keiki. VICTORIA BUDIONO / VBUDIONO @ State Sens. Kurt Fevella (R, Ewa Beach-Ocean Pointe-Iroquois Point ), left, and Sharon Moriwaki (D, Waikiki-Ala Moana-Kakaako ) advocated Friday for bills that promote economic security and equity for children, affordable child care programs, preschool and other causes at the state Capitol rotunda. Advocates are intensifying their efforts to push for improved family benefits for Hawaii's children as key bills addressing these issues remain stalled in the Legislature. The Paid Family &Medical Leave bills—House Bill 755, HB 695, Senate Bill 852 and SB 1054—seek to provide working families with paid time off to care for a new child, recover from illness or assist a loved one. While the nation remains the only developed country without a national paid family leave program, 13 states and the District of Columbia have implemented similar laws. Advocates, including the Hawaii Children's Action Network, are calling on the state to join them. HCAN is also advocating for an increase in the Child and Dependent Care Tax Credit—HB 753. The cost of preschool in Hawaii averages over $13, 000 per year, and working families are in dire need of help with child care expenses, the organization said. In 2023, Hawaii lawmakers took an initial step to support families by quadrupling the maximum amount that taxpayers can claim for child and dependent care expenses. However, a cap on the percentage of care expenses that can be claimed with the CDCTC makes it nearly impossible for families to access these increased amounts. The bill proposes increasing the CDCTC percentage cap, allowing working families to receive more assistance for child care costs. Don 't miss out on what 's happening ! Stay in touch with breaking news, as it happens, conveniently in your email inbox. It 's FREE ! Email 28141 Sign Up By clicking to sign up, you agree to Star-Advertiser 's and Google 's and. This form is protected by reCAPTCHA. Both HB 755 and HB 753 are stalled in the House Finance Committee, and related bills have not been heard after passing their first hearings. State Rep. Jeanne Kapela (D, Volcano-Hawaiian Ocean View ) told the Honolulu Star-Advertiser that the ongoing federal instability has had a trickle-down effect on state legislation. She explained that the uncertainty in federal funding has made it difficult for the state to plan and allocate resources for essential programs. 'The problem is that when you look at what's happening at the federal level, there's a trickle down to our state, ' Kapela said. 'It's hard for the state to figure out what to do here, and what gaps are we going to need to fill ?' She added that the uncertainty surrounding funding has caused delays in passing important bills like paid family leave and tax credits. Kapela emphasized that while some bills have been stalled, there is still potential to make progress, particularly if there is a related legislative vehicle. 'We're still at a point where if there is a vehicle that's related to something, we could potentially do something, ' Kapela said. 'We're not at the end, but we really have to figure out how to save money on the state side so we can come back and fix the holes that we're going to ultimately have to fix.' She noted that the state might have a clearer financial outlook once Congress passes its budget bill in March. Nicole Woo, HCAN's director of research and economic policy, explained that nearly half of Hawaii's children live in households experiencing financial hardship. While almost 1 in 8 are in poverty, an additional 1 in 3 live in households that aren't officially poor, but still struggle to afford the basics. In testimony for HB 753, Aloha United Way argued that tax credit adjustments like those in the bill are effective tools to reduce poverty and stabilize families, especially during times of crisis or when care-giving requires a family member to leave paid employment. The organization highlighted that the proposed changes would provide much-needed financial relief for ALICE—asset-limited, income-constrained, employed—families, who are employed but earn too little to meet basic living costs. The 2024 State of ALICE in Hawaii report showed that 40 % of Hawaii's residents are considered ALICE, and 15 % of households are struggling with the financial costs of caregiving for someone other than a child. Woo also advocated for the passage of the Paid Family &Medical Leave program, arguing that paid leave benefits children by supporting their parents. She cited research through HCAN showing that states with paid family leave enjoy significant health, social and economic benefits, particularly for working women, who are healthier, more economically secure and more likely to remain in the workforce. The bill would provide up to 12 weeks of parental, care-giving, deployment or safe leave per year, along with up to 26 weeks of medical leave, in line with Hawaii's law on temporary disability insurance.
