Princess Health and Feds strengthen anti-discrimination health rules. Princessiccia

Princess Health and Feds strengthen anti-discrimination health rules. Princessiccia

disabilities federal regulation gender disparities health health care health care access health care reform health communication obamacare Patient Protection and Affordable Health Care Act

Gusty 13:20 Add Comment

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By Danielle Ray
Kentucky Health News

The Department of Health and Human Services issued rules Friday in an effort to ensure equality in health care for women, the disabled and people who speak English as a second language.

The new provisions protect women from discrimination not only in the health coverage they obtain but in the health services they seek from providers. They also prohibit denial of health care or health coverage based on a person's sex, including discrimination based on pregnancy, gender identity and sex stereotyping.

The rule also requires providers to take reasonable steps to provide communication access to people with limited English proficiency. In addition, it requires that providers make electronic information and newly constructed or altered facilities accessible to individuals with disabilities, including providing auxiliary aids and services.

HHS Secretary Sylvia Burwell called the rule "a key step toward realizing equity within our health care system." She said in an agency news release that it reinforces the central goal of the Patient Protection and Affordable Health Care Act, to improve access to quality health care.

The rule covers any health program or activity that receives federal funding, such as providers who accept Medicare or Medicaid; any health program that HHS administers; and federal- and state-based health insurance marketplaces and insurers that participate in them.

The new rule implements Section 1557 of the 2010 health-reform law, which is the first federal civil-rights law to prohibit discrimination based on sex in federally-funded health programs. Previously, civil rights laws enforced by the agency's civil rights office barred discrimination based only on race, color, national origin, disability, and age.

The rule does not resolve whether discrimination on the basis of an individual�s sexual orientation status alone is a form of sex discrimination under the reform law. However, the provisions leave room for the agency's civil-rights office to evaluate complaints that allege sex discrimination related to a person�s sexual orientation to determine if they can be considered sex stereotyping, which the rule prohibits. In cases where religious freedom would be violated, health-care providers are not required to follow the regulation.

A summary of the new rule can be accessed here.

Princess Health and Kentucky Center for Economic Policy report warns about impact of Bevin's proposed Medicaid changes. Princessiccia

Princess Health and Kentucky Center for Economic Policy report warns about impact of Bevin's proposed Medicaid changes. Princessiccia

economy federal spending health reform jobs Medicaid obamacare Patient Protection and Affordable Health Care Act politics prevention state budget state government

Gusty 13:15 Add Comment

By Danielle Ray

Kentucky Health News

A research group with a liberal outlook warned Monday that Republican Gov. Matt Bevin should be careful in changing the state Medicaid program.

The Kentucky Center for Economic Policy said the state�s expansion of Medicaid eligibility under Democratic Gov. Steve Beshear has increased health screenings and job growth in health care.

Tobacco counseling and interventions increased 169 percent from 2013 to 2014, the first year of the expansion, the report noted. Influenza vaccinations went up 143 percent and breast cancer screenings increased 111 percent, it noted.

In addition, Medicaid expansion brought Kentucky health-care providers nearly $3 billion through mid-2015 and resulted in a 4.6 percent job growth in the health-care sector from 2014 to 2016, according to the report.

�No matter how you look at Medicaid expansion in Kentucky, it�s clear it has had a positive effect on access to health care that will improve our state�s economy and quality of life,� Jason Bailey, executive director of KCEP, said in a news release.

However, Bevin says the state can�t afford to have more than a fourth of its population on Medicaid and is seeking a waiver from the federal government to make changes in the program, such as �skin in the game� for beneficiaries: co-payments, deductibles or health savings accounts, as used in a year-old experiment in Indiana, which he has cited as an example.

The KCEP reports says the Medicaid waiver Bevin is seeking could result in additional costs to recipients and benefit changes. Arkansas was the first state to design a Medicaid expansion using such a waiver. So far, five other states have implemented similar waiver-based programs.

Waiver programs differ from standard Medicaid expansion in that they utilize some or all of the following: health savings accounts, a cost-sharing account to be used for health care expenses; lockouts, periods in which recipients who have been dis-enrolled for failure to pay premiums are barred from re-enrolling; and premium assistance, the use of Medicaid funds to buy private insurance plans.

These waivers are designed to grant states the freedom to enact experimental programs within Medicaid, so long as the programs continue to reflect the overall goal of Medicaid, increasing coverage of low-income individuals and improving overall health care, as well as efficiency and stability of health care programs that serve that population.

The Foundation for a Healthy Kentucky, which convened a meeting of Medicaid stakeholders last week, is holding off on making judgments of the proposed waiver program. �We believe that diverse input is essential to sustaining these gains, and to continue improving our health care system and health outcomes in Kentucky,� said Susan Zepeda, president of the foundation.

Zepeda said research the foundation has funded has shown a greater decrease in the number of Kentuckians who lack health insurance than any other state, which she attributes largely to Medicaid expansion adding about 400,000 Kentuckians to the rolls.

More than 1.4 million Kentuckians are enrolled in Medicaid, 39 percent of whom are children. Nearly 32 percent are enrolled under the expansion: childless adults in households that earn less than 138 percent of the federal poverty line, currently $33,000 for a family of four.

The KCEP report also asserts that Kentucky�s Medicaid benefits are on par with those of other states, specifically that 12 out of 13 of Kentucky�s optional benefits are also covered in at least 40 other states and territories. Kentucky Medicaid only covers services that are deemed medically necessary.

KCEP noted that Medicaid is a partnership in which the federal government funds a minimum of half of traditional Medicaid spending in each state, with poorer states receiving a larger federal match. In Kentucky, the federal share is about 70 percent. For people covered by the expansion, the federal government is paying the full cost through this year, but the state will pay 5 percent in 2017, rising in annual steps to the law�s limit of 10 percent in 2020.

The full KCEP report is at http://kypolicy.org.

Princess Health and Stivers calls for House bills on Kynect and Medicaid expansion, says Senate would vote on them to show where legislators stand. Princessiccia

Princess Health and Stivers calls for House bills on Kynect and Medicaid expansion, says Senate would vote on them to show where legislators stand. Princessiccia

health insurance Kynect legislation Medicaid obamacare Patient Protection and Affordable Health Care Act

Gusty 19:37 Add Comment

By Melissa Patrick
Kentucky Health News

Republican Senate President Robert Stivers challenged Democratic House Speaker Greg Stumbo Friday to send the Senate two House bills that would preserve the state's embrace of "Obamacare," in order to "have a full, fair debate on the issue" and see where legislators stand on it.

Robert Stivers

Stivers was referring to House Bill 5, which would require Kentucky to keep operating the Kynect health-insurance exchange, and House Bill 6, which would keep the state's current expansion of the federal-state Medicaid program.

Both would block Republican Gov. Matt Bevin's plans to change the programs, and with the Senate firmly in Republican control, their main sponsor, Rep. Darryl Owens, D-Louisville, has said he doesn't expect them to become law. Stivers noted that the bills aren't moving, despite being sponsored by several leaders of the House's Democratic majority.

�I would surmise that what they�re doing is just pandering and playing to a political base even though they don�t believe it�s good,� he said. �If they truly believe it's good, then vote them on the House floor.� Referring to House Speaker Greg Stumbo, he added, �If he votes it on the House floor, we'll vote 'em on the Senate floor.�

Stumbo said it was interesting that Stivers is attacking Obamacare when Bevin's plan for Kynect will use the federal health-insurance exchange, Don Weber reports for cn|2's "Pure Politics."

�He�s dismantling our Beshearcare here in Kentucky that Kentuckians were so happy to have. So, I'd be happy to have that discussion."

Former Gov. Steve Beshear, founder of non-profit Save Kentucky Healthcare, said in a press release that Stivers and Republican leaders are �once again touting misinformation about Kynect and the state of health care in Kentucky.�

Stivers claimed that the federal Bureau of Labor Statistics showed that the state had lost 3,500 health-care jobs while Beshear had promised that the expansion of Medicaid would add 5,400 such jobs in the state by bringing more people into the health care system, creating jobs and tax revenue.

Actually, BLS data show that while hospitals lost employment, overall employment in the health-care and social-assistance sector has gone up 4.6 percent since Obamacare was fully implemented in January 2014, compared to 3.1 percent job growth in all other Kentucky sectors, says Jason Bailey of the Kentucky Center for Economic Policy. (KCEP chart)

Beshear cited that data, adding, �Just last week Governor Bevin�s own administration released data showing that the educational and health services sector in Kentucky gained 4,200 jobs in 2015 alone.�