Some Kentucky lawmakers want to make it mandatory for some Medicaid participants in Kentucky to work, but experts say that would disproportionately affect people with mental health or substance use disorders.

House Bill 695 would require able-bodied adults with no dependents to work - and prove it - to receive health care.

Kentucky currently has a voluntary program, with job training and opportunities for community engagement, but Emily Beauregard - executive director of Kentucky Voices for Health - explained it isn't required for Medicaid eligibility.

"The majority of Kentuckians with Medicaid coverage are already working," said Beauregard. "They're working full time, part time. They're students, they're caregivers, taking care of children or older family members, people with disabilities."

Supports of work requirements argue the current system incentivizes people not to work, and argue the change will help alleviate staffing shortages.

Meanwhile, Congress is considering deep cuts to Medicaid, around $880 million over the next decade.

Groups like the Kentucky Center for Economic Policy say that would disproportionately affect Kentucky, which is one of the top ten states for the share of its population covered by Medicaid.

Valerie Lebanion teaches local parenting classes in Whitley County. She said most of her clients rely on Medicaid for health coverage.

She said she believes increased red tape around the program would end up hurting families.

"When moms and dads are sick, they can't take care of their children," said Lebanion. "They can't take their children to school, get their children off to where they need to be, or even to take care of their children."

Beauregard said the state would also end up paying more for the administrative work needed to track and document mandatory work requirements.

"It doesn't make sense economically," said Beauregard, "and it puts an additional burden on hard-working Kentucky families who are doing everything right and end up falling through paperwork cracks."

A recent poll from the health policy and research organization KFF found 96% of participants said Medicaid is either important or very important to their community - and 82% said lawmakers should leave Medicaid spending unchanged or increase funding.

As Republican lawmakers consider cutting billions of dollars in Medicaid services, a new report reveals the proposed reductions could affect thousands of military families in Pennsylvania. The Georgetown University Center for Children and Families says more than 850,000 people with TRICARE, the military's health insurance, also rely on Medicaid.

Retired Army Brigadier General George Schwartz points out that one in 10 children of active-duty military depends on Medicaid for additional health coverage, and warns that without proper coverage for their families, service members may leave the military for careers with better benefits, which would affect recruitment.

"And as those young people reach the age where they're eligible for military service, or the military is competing with private industry and all sorts of organizations for these young people. And so that, from a mission readiness standpoint, this is a matter of national security," he explained.

Pennsylvania is home to more than 2,500 active-duty military members, and more than 111,000 veterans and military contractors. The budget reconciliation bill is in the Senate with a vote expected by the end of June. Republicans are pushing for $2 trillion in federal spending cuts.

Medicaid also serves 40% of children in the United States with a benefit that allows them to receive preventive and ameliorative care.

Joan Alker, executive director, Georgetown University Center for Children and Families, said Medicaid is vital for service members whose kids need more complex medical care.

"The TRICARE benefit package just isn't enough, so Medicaid is making TRICARE work for those families by covering the high cost of services and some benefits that those children otherwise would not have access to," she explained.

Schwartz served in both the Army Reserve and the Army National Guard and said most of his military experience has been as a citizen soldier. He added Medicaid cuts would also affect veterans and their families, since around 50% of young people in the nation currently use Medicaid for their health coverage.

"I am very concerned that this could affect those citizen soldiers too, because it was only since 911 that TRICARE was extended to reservists and National Guardsmen because it was viewed as a matter of improving the readiness of the reserve components," he continued.

According to the report, an estimated 3.4 million children of veterans depend on Medicaid for their health-care coverage.

Medicare loses $60 billion to $80 billion a year to fraud and this year, for Medicare Fraud Prevention Week, your local Senior Medicare Patrol has good advice on how to spot a con.

There are plenty of scams to be aware of.

Karen Joy Fletcher, communications director with the nonprofit California Health Advocates, said beware if a caller asks to verify your Medicare number, claiming the program needs to send out a new type of card.

"This is just a way for people to steal people's Medicare number," Fletcher explained. "To commit identity theft, and to defraud Medicare, ordering services or items that they most likely will never receive."

Caregivers can be on the lookout for medical equipment arriving at the house even though the beneficiary never ordered it. Another red flag? A stranger may approach you in a parking lot asking you to sign up for new, free Medicare services like house cleaning or meals, which are then fraudulently billed to the government.

Fletcher encouraged people to check their Medicare summary notices online at MyMedicare.gov on a regular basis to make sure everything is in order.

"It's a good way to see if Medicare is being charged for things that maybe somebody never received, or from doctors they've never seen," Fletcher pointed out.

Another scam involves tricking people into unknowingly signing up for hospice care. It is especially dangerous, because once a person is on hospice, Medicare will only approve palliative care and could mistakenly deny an essential surgery or medication.

More than 1.5 million people in Tennessee, or 20% of the state's population, rely on health insurance provided by Medicaid.

Maddie Michael, Tennessee government relations director for the American Cancer Society Cancer Action Network, said access to health care coverage is one of the greatest predictors of whether someone survives their cancer diagnosis. She added cuts to Medicaid, also known as TennCare, could mean people lose access to routine cancer screenings and early detection tests.

"Without this insurance and without access to this care, there will be late-term diagnoses for cancer," Michael asserted. "Which are more costly to the patients, more costly to the state, and have lower survival rates, unfortunately."

Ten Tennessee advocacy groups, including the American Cancer Society Cancer Action Network, gathered Tuesday outside the offices of Sen. Marsha Blackburn, R-Tenn., and Sen. Bill Hagerty, R-Tenn., calling on them to protect Medicaid funding for Tennesseans. The Senate is set to vote on the proposed budget by the end of June.

Michael argued cutting Medicaid will have an especially big effect on cancer patients in Tennessee's rural and low-income areas, which rely heavily on the program for services.

"Rural communities already have higher cancer death rates than their urban counterparts," Michael pointed out. "That's often due to barriers to care, like hospital closures, which we've seen across Tennessee, and transportation issues. When you take away someone's health insurance, you're going to make those challenges in rural areas even worse."

Michael noted Tennesseans can express their concerns at FightCancer.org.


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