On January 12, 2018, the Centers for Medicare and Medicaid Services (CMS) approved a Section 1115 demonstration waiver in Kentucky, entitled "Kentucky Helping to Engage and Achieve Long Term Health" or KY HEALTH. The overall demonstration includes 2 major components: (1) a program called Kentucky HEALTH that modifies the state's existing Medicaid expansion and applies new policies to the current Medicaid expansion population, as well as most other adults covered by Medicaid; and (2) a Substance Use Disorder (SUD) program available to all Medicaid enrollees. Kentucky implemented a traditional Medicaid expansion, according to the terms set out in the Affordable Care Act (ACA), in January 2014. Subsequently, Governor Bevin, who ran on a platform to end the Medicaid expansion and dismantle the State-Based Marketplace, was elected in December, 2015. Post-election, the Governor instead decided to seek a Section 1115 waiver to change the state's traditional Medicaid expansion. On the same day that CMS approved Kentucky's waiver, Governor Bevin issued an executive order directing the state to terminate the Medicaid expansion if a court decides that one or more of the waiver provisions are illegal and cannot be implemented. This fact sheet summarizes key provisions of Kentucky's approved waiver.
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