Kentucky receives $57.9 million to set up insurance exchange

Kentucky received $57.9 million Wednesday to help set up a health insurance exchange or marketplace — though lawmakers have made no move to make that happen. Kentucky is one of 10 states to receive this latest round of federal insurance exchange establishment funds, which totals $230 million. Of these 10 states, Kentucky received the highest sum by several million.

Of the 10 latest states to receive grants, seven of them have adopted a plan or made substantial headway, reports Richardo Alonso-Zaldivar for The Associated Press. In the exchange, considered one of the cornerstones of the new health care law, individuals and employees of small businesses can choose from several plans whose benefits coverage packages have been pre-approved by the state and federal governments.

So far, 30 states and the District and Columbia have received grants. Of those, only 13 and the District of Columbia have adopted a plan for how to proceed. States have until Jan. 1, 2013.

"Kentucky has not determined whether it will establish a health benefit exchange in light of challenges to the Affordable Care Act and the lack of federal guidance and a tangible federal exchange model to consider," said Kerry Richardson, communications director for the Office of Gov. Steve Beshear, said at the end of January. "However, impending ACA deadlines require considerable planning, evaluation, design and development of systems to address exchange issues whether the state or the federal government operates the exchange, and we are engaged in those efforts."

In September 2010, the Kentucky Cabinet for Health and Family Services' Office of Health Policy received a $1 million exchange planning grant. In August, it received another $7.7 million to fund information technology systems. No bill has been introduced that would establish a state-based health insurance exchange so far. (Read more)

Lawmakers hear more complaints about managed care

Patients with mental illness are being denied medication, forced to try cheaper drugs that have already been proven not to work for the patient, or not getting them in time because of delays in approval. These were some of the complaints of the state's new Medicaid managed-care system, reports Deborah Yetter of The Courier-Journal.

"If this is how it's going to be, it is scary," Dr. Scott Haas, chief medical officer of the Bluegrass Mental Health/Mental Retardation Board, told the state Senate Health and Welfare Committee Wednesday. "It is dangerous, and it ultimately is going to cost us a lot of lives."

The testimony is the latest that highlights the weaknesses of managed care, which the state changed to on Nov. 1 to for 560,000 Medicaid recipients living outside the Louisville area. Executives of the three companies hired to provide the care — CoventryCares of Kentucky, Kentucky Spirit Health Plan and WellCare of Kentucky — last week pledged to do better.

The majority of yesterday's testimony focused on the system's problems in dealing with mental illness, but Deb McGrath, executive director of the Epilepsy Foundation of Kentuckiana, said she's been inundated with "complaints about delays or rejections in medications patients need to control seizures," Yetter reports. "Something has to be done," McGrath said. "It's just a vicious cycle." (Read more)