The report shows Kentucky is one of the states that has cut general funding for K-12 education most deeply. From fiscal years 2008-2018, Kentucky spent 15.8 percent less in state formula funding per student, which is the primary form of state K-12 funding and other related expenses such as bus transportation, contributions to school employees, and pension plans, said Michael Leachman, who wrote the report for the Washington, D.C.-based group.
Only Oklahoma and Texas rank worse than Kentucky, said Kenny Colston, communications director for the Kentucky Center for Economic Policy. “Kentucky is one of seven states that cut core funding as recently as this past fiscal year. Only Mississippi and West Virginia cut more in the latest fiscal year,” he said.
“States must invest in their schools, so that children can receive the education they need to succeed in life,” said Colston. “With looming pension obligations, this report is once again evidence of the need to clean up the tax code of special interest loopholes to help Kentucky reinvest in our state’s schools, among other needs.”
The erosion in support for K-12 education has damaging economic consequences for the state — both now and in the future, according to Colston. He said the cuts can undermine proven education reforms such as reducing class sizes, improving teacher quality, increasing learning time and expanding early childhood education.
“The state cuts have meant more pressure on Kentucky’s local school districts. Poorer districts, especially those in the struggling coal fields, simply cannot compensate for the lost revenue. Many districts are having to make difficult budget decisions about reducing or eliminating staff, student supports, courses, and art and music programs. In addition, many are unable to give staff raises or meet facility needs,” Colston said .
Elliott County Schools Superintendent Debbie Stephens said the cuts have affected student/teacher ratios.
“We have been unable to maintain the number of staff that enables us to keep our student/teacher ratio numbers as low as we would like,” Stephens said. “We are also unable to provide up-to-date instructional resources, especially textbooks, for many of our classrooms.”
“This report underscores the fact that education in the state of Kentucky is woefully underfunded,” Fayette Superintendent Manny Caulk said. “That does not reflect the core values of our Commonwealth, and we owe it to our children to do better. The findings are especially timely in light of the current educational landscape in which schools already reeling from consecutive years of funding cuts that have not been restored now face mid-year budget reductions, uncertain fiscal obligations from pension reform, and the implementation of a new educational model on top of a system that is inadequately funded.
“On the eve of a possible special session and a regular session beginning January 2, I have faith in our elected officials to tackle tax reform and the pension crisis in a comprehensive way that puts funding for Kentucky education back on track. We are committed to working closely with our delegation in the House and Senate, as well as other elected officials, state agency leaders, education advocacy groups, and educators to find workable solutions that put students first,” Caulk said.
(This poem is dedicated to my Father-in-Law Glenn Wright who
is very, very close to saying goodbye to us this evening. Dad is at
the stage where if you are merciful, please pray for Dad to let go,
to go to sleep. He told me his wishes several times, to let Him go.)
I was graced to be born in the Blue Ridge Mountains of Virginia
One of Yahweh’s beautiful landscapes for the human eye to see
Lived many a year on the land where Mr. Crockett called home
All are lands where the Fiddle and the Banjo still sing their songs
Too lay down in the ground where Mr. Boone once had a Fort
Blessed to have been born in one of God’s beautiful Mountain Resort
We all must face that rainy day, as for me I wish to be lain, under Bluegrass
(Writing this piece this evening as I was working on the sections I realized even more things that we two had in common. Either way, I salute you Sir, you are a very good Father-in-Law, thank you for giving me such a wonderful Lady and Son.)
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The detective testified that Belt was upset that Jessica Durham’s husband stole $200 from him. The detective told the court that Belt planned to take Durham and her son back to his house and hold them until he got the money he was owed. Detective Charles Brandenburg told the court that on September 8, Belt tricked Durham into thinking her husband was at his home.
“So she went to the end of the hallway, where David was supposed to be, the bedroom. She went into the bedroom. David was not there. She was struck in the back of the head with a metal object by Lonnie,” Brandenburg said.
“She went on to say, when she got back in the vehicle she was blindfolded and tied up, and her head was bleeding. Her small child, her 5-year-old son was in the back seat,” Brandenburg testified. “She could hear him say, ‘Mommy you’re bleeding, Mommy you need a doctor.'”
The detective went on to say that Belt took Durham to different sites on that Friday, beating her repeatedly. Eventually, police say Belt took Durham to the woods and kicked her off a cliff. She fell 77-feet. According to the officer, Durham was there for nearly 24 hours before hikers found her.
Belt told detectives that he killed five-year-old James Spoonamore because he witnessed the assault.
“He finally admitted to taking James, putting him in a car and driving him to a separate location, in the same wooded area, across Sparks Ridge Road, where he hit James in the back of the head with a metal object multiple times.”
Investigators said they have not been able to locate the hollow pipe Belt allegedly used in the attack.
Police charged Lonnie Belt with murder, assault, kidnapping an adult, kidnapping a minor, and tampering with physical evidence.
At the end of testimony, the judge decided there was enough evidence to send the case to a grand jury.
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Toward the end of part one I was speaking of the Ratings Board for the VA and how crooked they are and have been. In the guidelines for how the VA Ratings Board is supposed to conduct themselves it is stated that if their own Doctors agree with the Vet like their Neurosurgeon did in October of 2012 concerning the MRI I was finally able to get, that the Board would have to side on the side of the Veteran. Those guidelines also say that if the Veteran goes to civilian Doctors and those Doctors in writing agree with the Veteran that it is “reasonable to believe” that an active duty injury “could have caused” the veterans issues that they are trying to get a disability increase on then the Board has to side with the Veteran. As most any and all Veterans who have received negative answers at these Boards of Inquiry know, the VA personnel who are being paid by the VA, they pay no attention to those guidelines. As I said yesterday in part one, poop flows downhill, you know that these actions have to be being dictated to them from higher up in the VA chain of command. Otherwise why would these underlings be going against the very guidelines that they are told to uphold?
From about August of 1984 up until the heart attack I had while living in Ocala Fl in March of 1999 I suffered with not only my legs, hips and low pack being in constant pain, I suffered horribly with chest, neck, left shoulder and hand pain from the un-diagnosed heart pains. In 1999 I was working on a dedicated account for J B Hunt and I had another heart attack while at a company safety meeting. I was 42 at the time and my boss didn’t figure it was something serious so he pointed me in the direction of the hospital and I drove myself there. It was a Saturday morning and it was flu season and the ER was full of Mom’s and kids. When I was able to finally get up the ramp and into the building I went to the check in window, told them what was going wrong with me, they thought that I was lying just trying to get in front of the line. They did check my blood pressure though and as normal it was about 110/70.They had me sit in the waiting room for 5 1/2 hours before they finally called my name. When they finally did an EKG they freaked out because of them seeing the heart attacks. 3 days later they did a 4 way by-pass as all my arteries were 100% closed. At that time it seems that even the heart Doctors were unaware that the body in attempts to save itself will grow small veins around the blockages and into the heart. Trouble is that by blood would close these just about as fast as the new ones could grow. Literally your body is in a race against itself as it tries to keep some blood going to the heart. This was the first time that I ever got a hospital to do an EKG, ever. Over a span of 14 1/2 yrs I was never able to get a VA Doctor to do that simple 30 second test. How many yrs of my life did their ignorance, arrogance, and laziness shave off of my life span? This also doesn’t include the fact that during this time I had no quality of life at all. I couldn’t play any kind of games with my kids and my whole life revolved around working (being a long haul truck driver) and when I wasn’t working about the only thing I ever did was to sleep.
After my insurance ran out three months after the heart operation I had to rely on the VA system for my meds because I had no other way to afford them. The company I was working for would not let me come back to work so I did the only thing I could do, I had to lie my way into jobs with small companies or starve and go homeless. In January of 2002 I was able to get on with a company in Knoxville Tn that I stayed with until January of 2004 when my health made it impossible to do my job, so I had to quit. As was very normal with the VA system they change who they get their medications with quite often so even if you are getting the same medication from one supplier for a few months the VA would then change and you would get the same medication (supposedly) but the pill would look totally different. It also was and sometimes still is common to get a medication bottle that just says the name of it and to take it once or twice a day or to take at bed time or before breakfast, but that would be all that was on the bottle. About the first of January 2004 I got one such bottle that simply said take it twice a day but not what it was supposed to be for, this was not uncommon. I tended to follow what the bottles said so I started taking it two times a day, about twelve hours apart. Within a few weeks I was feeling so wore out I could hardly function at all. I had to quit my job because I thought I must be having trouble with my heart again. In mid February 04 I was able to get a heart-cath done through the VA in Johnson City (Mountain Home) Tn. When these are done a Cardiologist always has to be present, this day I had a young Doctor named Israel Garcia as the supervisor. I remember the name because of what he did. Before the test he was looking over the medications that I was on and he came across one that he said I did not need to be taking because it is only used if the patient had a history of strokes and I had not had one. Thirteen days after he took me off the med I had a stroke, the very next day they put me back on it, I’m still on it. I have never been mad at the man because all people make mistakes, I don’t believe he meant to hurt me on purpose, I forgive him. Yet because of this stroke I was not able to work until April of 2009, this VA doctors mistake cost me a little over five years of work income for my family.
The stroke hit my left side which is my dominate side and I still feel some of the effects to this day, but not major, I’m used to it. Reality was that the medication I had been taking was a muscle relaxer so my taking it every twelve hours just about stopped my heart, as you know, the heart is a muscle. Now I was in a situation where I could not work at all and my family lost our home and we had to move into a ‘state apartment’. I was unemployed until I decided to lie my way into another driving job in April of 2009. I had to lie to get employment because the only job that I could do that I knew how to do was to drive a truck and no company would have hired me if they knew that I was ill. I felt as a husband and a dad I had to try to get our family out of the base living conditions we were living in, just barely surviving. My health for many years had mandated that the only work I could do was if I was sitting down and not lifting anything, that is very limiting in the employment spectrum. The left side of my face is still numb and I still have a little bit of trouble with objects coming quickly from my left to my right. Also I could only be on my feet for about ten minutes at the most before the pain in my low back and legs would force me to sit down, now day’s I am lucky if I can get 2-5 minutes before the pain puts me down and I am forced to use the power wheelchair the VA gave me back in 2007 all of the time.
I was able to work from April of 2009 until June of 2013 when I simply had used up every ounce of pain fighting ability that I could muster. In 2007 I had another heart-cath done in Johnson City at the VA and it showed that all of my grafts from the 1999 operation were 100% closed. Yet they refused to even try to do a balloon surgery to see if any of those grafts could be opened because in their words “that operation would probably kill me”. Folks, I know I am not the wisest person in the world but I have a question for you. When all of a persons arteries and grafts are totally closed and the only blood getting to the heart keeping you alive are those little veins I told you about earlier that grow around the blockages in a race for time, what does a person have to lose? You are going to die from this condition guaranteed! Yet the VA refused to do anything except give me more medications.
As I told you earlier I went back to work in April of 2009 for a small local company. I had resigned myself to the fact that I would simply work as long as I could expecting that one day I would simply go to sleep in a truck-stop somewhere and not wake up. I felt that the least I could do before I died was to give my family as much help financially as possible. Because I had been out of work for so long I didn’t even have the credits with social security to be able to leave them with even that check so I had to try to work as long as I could hoping I could work long enough to get those credits. Social Security and VA disability pensions are a poor mans life insurance for their families they leave behind. Because of the VA’s methods of operation I was going to not be able to leave anything for my family, this is why I had to try going back to work even though I knew I shouldn’t do it.
In September of 2011 I was in Atlanta having a trailer washed out for a customer and was leaning up against the outside wall of the business, it was a hot day and they had the big outside door propped open beside me. When they finished the trailer washout I stepped away from the wall and blacked out. I fell face first into the big metal hinges of that door busting my forehead open about three or four inches. The workers revived me and to make a long story shorter, I was taken unconscious in an ambulance to the nearest hospital which turned out to be less that a half mile away. The first three days I was there I was unconscious and remember nothing of it. Once I was awake the heart Doctors told me that when I got to the ER my numbers were 50/20 and dropping fast and that both of my kidneys had completely shut down, they told me that I would have been dead in another five to ten minutes if I hadn’t gotten there when I did. I was also told that the VA had me on four times too much blood pressure medicine and that it was what had made me black out. Once again I was minutes away from the VA killing me. While I was out on that third day they did a heart-cath on me, it was after that when I woke up. There were two heart Doctors talking with me about the condition of my blood flow. I told them what the VA Doctors had told me about why they couldn’t/wouldn’t try to balloon them open, I remember they just looked at each other and wagged their heads in disgust. Within the hour they had me in surgery where they were able to balloon open two of the grafts from the 1999 surgery and they put stints in them at that time. This is why I am still alive today was because of the quality of the Doctors at the Gwinnett Medical Center just outside of Atlanta.
These Georgia Doctors gave me a new med list to give to the VA Doctors and to no surprise they got upset about the new list. One of the meds is a very expensive one for the heart that is actually required by law for them to give to me because of my particular condition. The condition being when a person has no arteries open and all the person has for blood flow are stints in old grafts they must give you this medication. It took them twelve months before they agreed to do it and then it was only after a new VA Doctor I had been assigned went up the chain of command to insist they do it. I am not saying that all people or all Doctors at the VA’s around the country are worthless or evil, but many are and it seems that the chain of command above the Doctors are in many cases just plain evil. I know that the VA system goes through a huge amount of Doctors, it seems like every time you go to one of their clinics you have been assigned yet another new Doctor. Could it be that in many cases when a good Doctor gets a job with them that they see how crooked that system is and they decide to find somewhere else to work?
I am going to finish with one last kick in the privates that they are very guilty of, and that is they refuse to pay their own bills so you the patient ends up with all their medical bills laid against your credit. By their own rules they must pay those medical bills I have in Georgia, it has been almost five years now and they have paid nothing. By their own rules in a life or death emergency and you could not get to the nearest VA Hospital then the VA will pay that bill. I have been told several times that they believe that I could have made it to the VA in Atlanta so they have steadfastly refused to pay the $70,000 dollars in medical bills I have there. Folks, what part of arrived unconscious in an ambulance from a half mile away, five minutes from death do these people not understand? You have to believe that they can’t be that stupid so the other alternative seems to be is that they are that crooked, at least it seems that way to me. Last August my wife and I bought a house in Kentucky just outside of Lexington. We chose here because it is one of only two VA Hospitals I have ever heard good things about and in this twelve months we have been here I have been an inpatient twice already and they do actually seem to give a damn here unlike the other hospitals of theirs I have had experience with. But now about that $70,000 dollars on my credit that I can’t get off. When we bought the house I was forced to use the VA Loan program because I couldn’t get anyone else to finance us, not even the Credit Union that we have banked at for many years. Even through this loan, because my credit score was only 668 because of those medical bills our rate of interest is much higher than it should have to be, meaning that every month we have to pay more out-of-pocket of our set incomes for the house payment, leaving less for life’s other expenses. Okay, I’m done gripping about them, I know this was a long story folks, but I guarantee you this, everything I have said to you is true. As I said early on, I do not believe that anyone at the VA has a personal vendetta against me, I am just one of millions of service connected disabled Veterans who have been and are being treated like this. What is your opinion of the VA now?
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FRANKFORT — Labor groups filed suit in Franklin Circuit Court on Thursday claiming the recently passed Kentucky right-to-work law violates the state constitution’s prohibition on illegal takings and unequal treatment.
The Kentucky AFL-CIO and Teamsters Local 89 are asking the law be thrown out and seek an injunction prohibiting its enforcement, claiming it discriminates against unions while not prohibiting forced dues collections by other volunteer member organizations like the Chamber of Commerce and the Kentucky Bar Association.
The suit alleges that the law violates the constitutional bar on “illegal takings without just compensation” because it robs unions and their members of unreimbursed expenses for negotiating wage and benefits for workers who choose not to pay union dues or join the union.
After Republicans captured control of the state House of Representatives last year, giving the GOP control of the governor’s office and both legislative chambers, the General Assembly quickly passed right-to-work legislation in the first week of the 2017 General Assembly. The law prohibits unions from requiring workers at union work places to pay dues in support of collective bargaining expenses.
Republican Matt Bevin urged its passage and credits the legislation for subsequent announcements by Braidy Industries to construct an aluminum mill near Ashland and Amazon to expand operations in northern Kentucky.
“It’s shameful that groups like the AFL-CIO and Teamsters are playing political games at a time when Kentucky is experiencing unprecedented economic development growth,” said Amanda Stamper, Bevin’s spokeswoman.
“This frivolous lawsuit threatens to hurt Kentucky’s families, robbing them of high-paying job opportunities — a good example of which are the 550 jobs coming to northeastern Kentucky as a result of the new right-to-work law,” she said.
House Speaker Jeff Hoover, R-Jamestown, who sponsored the legislation, said he’s confident it will stand up in court.
“Not only am I confident the Kentucky Right-to-Work Act is constitutional, but we are also seeing results we predicted when the bill was passed.”
But AFL-CIO President Bill Londrigan called claims that right-to-work laws improve a state’s overall economy a “total falsehood” aimed at attracting low-wage industries and dividing workers.
“In other states where right-to-work laws have been implemented,” Londrigan said, “wage rates have gone down. We found that across the United States when we compare right-to-work states to non-right-to-work states, there is a significant amount of wages that workers make, ranging from $1,500 to $5,000 a year less a year in right to work states.”
Senate President Robert Stivers, R-Manchester, said the law is constitutional and pointed to a recent federal district court that dismissed a suit challenging Wisconsin’s right-to-work law.
But Irwin Cutler Jr., one of the attorneys for the AFL-CIO and Teamsters, said that’s only half the story.
That suit challenged the Wisconsin law under provisions of the federal constitution. But a second suit that challenges the law under the Wisconsin constitution won a favorable lower court decision. So did a similar suit in West Virginia. All three suits are under appeal.
Cutler and William Johnson, another attorney representing the union groups, said they are challenging the law under Kentucky’s constitution because it has stronger “illegal takings” and equal treatment provisions than the U.S. Constitution.
“In each state, you have to look at how the law that was passed comports with the constitution of that state and we think that is a strong point in our suit,” Johnson said.
Cutler said federal law requires unions to represent all workers at a worksite with a collective bargaining unit, even if they can’t collect dues from some workers.
“Under this law, unions still have the obligation to represent every worker in the plant, and yet the only ones who pay for that service are the ones who decide they want to,” Cutler said. “That constitutes, under the Kentucky Constitution, an unlawful taking of the services, the property, of the labor union and its members.”
The suit also contends the right-to-work law is discriminatory because it applies only to unions but not to other groups which require membership dues. (In fact, the law specifically exempts several membership organizations, including chambers of commerce and the Kentucky Education Association.)
Cutler said Kentucky law actually requires Chambers of Commerce to collect dues to pay for their services — “yet unions are required to pay for their services and are prohibited from charging dues unless someone voluntarily wants to pay for that service.”
Chapter 102.020 of the Kentucky Revised Statutes authorizes chambers of commerce and specifies articles of incorporation. It says in part: “The annual dues of the members of this corporation shall be not less than twelve dollars ($12), payable as provided in the bylaws of the corporation.”
Ashli Watts, Vice President of Public Affairs for the Kentucky Chamber of Commerce, didn’t dispute the language of that statute but said it is open to interpretation. She said the state chamber supports right-to-work.
“As the last southern state to pass right to work, Kentucky is already benefiting from this law that’s only been in effect 5 months. The point to be made is that membership in the Kentucky Chamber, and other chambers of commerce, is voluntary,” Watts said. “We are confident that the law will be upheld, like it has been in other states.”
Ronnie Ellis writes for CNHI News Service and is based in Frankfort. Follow him on Twitter @cnhifrankfort.
(THIS ARTICLE IS COURTESY OF THE NEWS SITE POLITICO)
When former Indiana Gov. Mike Pence embraced Obamacare’s Medicaid expansion with conservative twists — such as requiring enrollees to contribute to their care — critics lamented poor people would be locked out while backers cheered the program’s focus on personal responsibility.
Neither side’s expectations were quite borne out. Two years later, as the program emerges as a national model thanks to Pence’s role in the Trump administration, the reality on the ground shows what happens when political philosophy collides with the practical challenges of providing health care to tens of thousands of people, many of them in crisis.
Advocates for the poor in Indiana argue that liberal fears of depressed enrollment were overblown. More than 400,000 Hoosiers are enrolled, despite state requirements that low-income residents make nominal monthly contributions to their care or face stiff penalties.
Likewise, Republicans’ contention that the system would promote personal responsibility and prod beneficiaries to ration their care and make better decisions about what treatments to seek also turned out to be overly optimistic.
By all accounts, the expansion — known as the Healthy Indiana Plan 2.0 — has made a difference. Health officials in Scott County, Ind., a poverty-stricken community about 30 miles from Louisville, Ky., paint a picture of a program that’s bolstered a patchy social safety net — especially during a major HIV outbreak triggered by the opioid epidemic — without bankrupting the Hoosier State or punishing enrollees.
To be sure, the program isn’t perfect, they say. But they overwhelmingly give more positive reviews than not.
“I feel that it has been a good success,” said Dawn Sanders, an outreach worker for Covering Kids & Families of Indiana, a statewide consumer group working in Scott County. “It’s working.”
Healthy Indiana’s influence is expected to increase in the months ahead whether or not Obamacare survives, as state officials and the Trump administration look to replicate some of its conservative features, potentially unleashing a wave of new state restrictions on how non-disabled adults get coverage without any action from Congress.
“The Healthy Indiana Plan has long been, and continues to be, a national model for state-led Medicaid reforms,” HHS Secretary Tom Price wrote in response to senators after his confirmation hearing.
“It is important that Medicaid’s design helps its members to transition successfully from the program into commercial health insurance plans, as [Healthy Indiana’s] consumer-driven approach and underlying incentive structures encourage,” he told lawmakers.
Seema Verma, meanwhile, a Pence ally who helped design the program before she was tapped to run CMS, now has the power to give states greater flexibility to reshape their own programs according to conservative principles.
Kentucky and Arizona have already borrowed aspects of Indiana’s plan while others, including Wisconsin, could move to enact new limits that resemble the approach.
Indiana’s plan also provides a measure of political cover to lawmakers in red states where supporting Obamacare’s coverage expansion is still deeply controversial. Republicans across the country have found it easier to back an expansion of government-funded health care for the poor if it more closely resembles a private insurance market. Yet liberals remain deeply skeptical because of the way the system is designed to cut people off who don’t make monthly payments, at least temporarily.
Both sides could find their assumptions challenged based on the experience in places like Scott County.
The Indiana plan does punish people above the poverty line who stop making monthly contributions by locking them out of coverage for six months. But because most enrollees have incomes below the poverty line, lockouts have been rare, according to state evaluations of the first year of the program. Instead, those below the poverty line who don’t pay are bumped from plans with more generous benefits — including coverage of vision and dental care and better prescription drug benefits — into skimpier plans with higher out-of-pocket costs.
“It sounds like, ‘Oh my gosh, people are going to have to pay.’ But people that were uninsured were paying for it already,” if they go to the doctor, said Beth Wrobel, who runs a federally qualified health center in Valparaiso, in the northern part of the state.
Diabetic patients who visited Wrobel’s clinic before the start of Healthy Indiana incurred significantly higher costs paying for their regular medical supplies and routine testing, she said. Now, under the more generous benefit package, “the most you have to pay is $26 a month, and that’s at the high end. Most of our patients pay between $1 and $10 a month,” Wrobel said.
“For the same amount that you were paying at that moment for your diabetic care, you could get medical, dental, behavioral health, optometry and pharmacy. [Healthy Indiana] treated the whole body,” she said.
Randy White, CEO of Fayette Regional Health System in Connersville, in the east-central part of the state, agreed that Healthy Indiana “is not harsh.”
If the liberal specter of a punitive system pushing out enrollees hasn’t quite materialized, neither has conservatives’ vision of a market-like system where patients with “skin in the game” make hard choices about their own health spending. That’s because family members, health workers and nonprofits are helping cover their out-of-pocket costs.
“With some people, I think [personal responsibility] might be a little bit lost,” Sanders said in her office at the Scott County Partnership,a nonprofit. “We try and do what we can in the little bit of time we have with them. But you can only give them so many pamphlets.”
About 2,100 of the enrollees who gained coverage through Indiana’s expansion live in Scott County, a poor, sparsely populated area that gained notoriety where an HIV outbreak took off two years ago, fueled by needle sharing and opioid abuse.
Sanders recalled how a man with substance abuse problems signed up for health coverage in the small town of Austin, Ind., which had set up a “one-stop shop” to get people enrolled and provide medical services like HIV screenings and vaccinations.
“He knew he had hit rock bottom. And he knew he needed help,” Sanders said. “He no longer lives in the area, but he had to be able to get away from this. He has stayed clean this whole time. He now has his children back. We have quite a few success stories, as far as that’s concerned.”
As of early April, there were 216 county residents with HIV, according to Scott County Health Department Administrator Michelle Goodin, but roughly three-quarters of the patients don’t have enough of the virus in their blood to spread it to others. New cases are still being diagnosed.
“We’ve got about 30 to 40 people usually that are HIV-positive in our facility,” said Sheriff Dan McClain, whose staff helps prisoners apply for Medicaid so that they can receive benefits, including mental health and substance abuse treatment, as soon as they are released. “We offer them a test for HIV and … we offer to sign them up for HIP 2.0,” he said.
With an ad-hoc support network fortifying the safety net, some liberal groups and Democratic lawmakers question whether the conservative tweaks are really adding value or simply burdening enrollees with unnecessary complications. Without those hurdles, they say enrollment would be even higher.
Progressives also fear that if the Indiana model is embraced in states that initially did traditional expansions of Medicaid, it would erode enrollment gains.
“Work requirements, lock-out periods, time limits and imposition of onerous premiums and cost-sharing on Medicaid families, who are generally living on a budget of roughly less than $15,000 per year, are not only punitive but also counterproductive in the long-term,” Sen. Ron Wyden (D-Ore.) and Rep. Frank Pallone (D-N.J.) wrote in a letter to HHS last month to discourage it from approving additional restrictions, many of which would be program firsts. “Requiring poor families to pay more than they can afford for care makes them less likely to access the care they need and less likely to maintain their coverage.”
State surveys of how Healthy Indiana is working present a fragmentary picture, and despite the program’s popularity in Indiana, there are some signs of hampered enrollment because of its complex structure and broader concerns about affordability. For example, roughly half of the enrollees in the more comprehensive benefit package worried about being able to afford their monthly payments. Left-leaning groups have used the data to raise flags about harmful implications for other states.
The first-year report also estimated that roughly 1,240 enrollees received financial help from nonprofits to pay their premiums, a paltry slice of overall enrollment. But residents here believe many more enrollees likely rely on family members, friends and others sources undetected by official surveys. Sanders and others pointed out that the premium cost of keeping someone covered in the program’s more generous benefit package — which includes vision and dental benefits as well as more robust coverage of prescriptions — is as little as $12 for an entire year.
“We’ve paid it out of our pocket many times at the office just to get them hooked up,” said Jeanni McCarty, a nurse at Foundations Family Medicine in Austin. McCarty said she has four family members affected by HIV and five relatives who have passed away from drug abuse-related problems.
Indiana officials by the end of the month will send CMS two more reports, including one that specifically examines the use of health savings-like accounts to help beneficiaries cover their costs. Pence’s successor, Republican Gov. Eric Holcomb, has already asked the Trump administration to extend the program through January 2021 with a handful of tweaks — though notably absent is a request to institute a work requirement as a condition of receiving benefits.
“We don’t want to put policies and programs in place that are not member-centric,” said Jennifer Walthall, secretary of Indiana’s Family and Social Services Administration. “Increasing barriers is not the name of the game.”