Tracking Changes to Medicaid in Kentucky

Medicaid Enrollment in Kentucky

Medicaid covers nearly 1 in 3 Kentuckians overall, and an even higher share of Kentucky’s kids – which is right around half.

Medicaid enrollment by eligibility type

Medicaid enrollment in Kentucky had been generally declining since the beginning of 2018 after reaching a high-point of over 1.4 million.

Since February, however, enrollment has risen as the COVID-19 related economic downturn has meant more people are turning to Medicaid for health coverage.

Note: Beginning in July, 2020 certain children ages 6 to 18 are counted under the Kentucky Children’s Health Insurance Program (KCHP) rather than Medicaid. For other monthly Medicaid statistics, visit  https://chfs.ky.gov/agencies/dms/dafm/Pages/statistics.aspx.

Special Temporary Medicaid Coverage

In response to the COVID-19 pandemic and subsequent downturn that led to hundreds of thousands of Kentuckians losing their jobs, and often their health coverage, Kentucky received permission from the federal government to provide Medicaid on a temporary basis to anyone who is uninsured and under 65 years old. This type of coverage is called presumptive eligibility (PE) – a form of which was already in place for low-income, uninsured patients who signed up for it when they had to got to the hospital.

This graph shows both regular hospital PE and the special COVID-19 PE.

Medicaid Enrollment by Race and Eligibility

Kentucky, like all states, has a long history of economic, political and social barriers to race equity – including health coverage. Even policies that have been repealed continue to reverberate in society today. Because of this, Kentuckians of color are disproportionately like to work in jobs that pay too little – and therefore more likely to qualify for Medicaid. Statewide, 13.3% of Kentuckians report as a race other than white.

Reasons Why Kentuckians Are Disenrolled from Medicaid

The Kentucky Department of Medicaid Services removes thousands of people from Medicaid coverage each month for dozens of reasons. The most common reasons are that Kentuckians’ incomes are higher than the limit or that they failed to provide information when the agency requested it.

It is possible many of those who lose Medicaid coverage for any number of reasons regain it later in the same month, or in the coming months. This is known as “churn.”

Recently, because the Families First Coronavirus Response Act required states to cease most disenrollments in order to receive more federal funding, the number of Kentuckians who lose coverage each month has dramatically fallen.